Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #121091

Naydi Perez, BS¹, Ana Patricia Ortiz, MS PhD¹, and Gilberto Ramos, DrPH². (1) University of Puerto Rico, Medical Science Campus, PO Box 365067, San Juan, PR 00936, 787 365-1188, nperez@stu.rcm.upr.edu, (2) School of Public Health, University of Puerto Rico, Medical Sciences Campus, Po Box 365067, San Juan, PR 00936

Introduction: During 2004, 45% of all births in Puerto Rico (PR) were performed through cesarean section. This represents a public health concern, as studies performed in other population suggest that cesarean section is a barrier for breastfeeding initiation.

Objective: To examine the association between cesarean section delivery and initiation of breastfeeding in a representative sample, by geographic health region, of 1,970 Puerto Rican women aged 15-49 years, who had their last born child during 1990-1996.

Methods: The study is a secondary analysis of data collected in the cross-sectional study Puerto Rico Reproductive Health Survey. Bivariate and multivariate logistic regression analysis was used to examine the association between type of childbirth (cesarean section vs. vaginal birth) and initiation of breastfeeding.

Results: The prevalence of cesarean section was 36.1%. In covariate adjusted multivariable logistic regression models, cesarean section was negatively related to breastfeeding initiation (OR=.61; IC 95%; .49, .76). Covariates that encouraged breastfeeding initiation included: having an associate degree (2.09: 1.47, 2.98), BS/postgraduate degree (3.13; 2.01, 4.86) (as compared to 0-8 years in school), having a job (1.28; 1.01, 1.62), baby brought to the mother during hospital stay (1.25; 1.01, 1.56), and breastfeeding persistence (1.67; 1.33, 2.11) and aid (1.37; 1.10, 1.70) offered by hospital personnel.

Conclusions: This is the first population based study to confirm that cesarean section is a barrier for initiation of breastfeeding in PR. Health education campaigns targeting hospital personnel and women who have cesarean sections should be developed, in order to increase breast feeding initiation among these women.

Learning Objectives:

• Describe the association of cesarean section delivery and the initiation of breastfeeding.
• Discuss the factors associated with breastfeeding initiation for a population of Puerto Rican women.

Keywords: Pregnancy, Maternal and Child Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.