241845 Does the mode of delivery affect breastfeeding?

Wednesday, November 2, 2011: 8:50 AM

Indu B. Ahluwalia, PhD, MPH , Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
Ruowei Li, MD, PhD , Division of Nutrition and Physical Activity, US Centers for Disease Control and Prevention, Atlanta, GA
Brian Morrow, MA , Division of Reproductive Health, CDC, Atlanta, GA
Objective: To assess the relationship between method of delivery and breastfeeding initiation and duration. Methods: This analysis, of the longitudinal Infant Feeding Practices Study II, examined method of delivery and breastfeeding (n=3026). The outcomes included breastfeeding initiation, breastfeeding at 4 weeks and mean breastfeeding duration. Delivery method was categorized into: vaginal delivery/not induced, vaginal delivery/induced, unplanned/emergency cesarean delivery, and planned/cesarean. SAS software was used for analysis and several confounders, including pre-delivery breastfeeding intentions and attitude, were assessed. Tukey-Kramer method was used to adjust for multiple comparisons. Results: After adjustment for maternal pre-delivery attitude and infant feeding intentions, there was not a significant association between delivery mode and breastfeeding initiation. Multivariable model assessing breastfeeding at 4 weeks postpartum, however, showed that compared to women who delivered vaginally, those who delivered vaginally-induced (adjusted OR (AOR)=0.55; 95%CI: 0-39-0.78) were less likely to breastfeed; and the association was not significant for those who had a planned/cesarean (AOR=0.96; 95%CI:0.58-1.56 ) or emergency/cesarean (AOR=0.72; 95%CI: 0.46-1.14). Duration was longest for those who delivered vaginally/not induced (adjusted mean=36.9 weeks), it was 33.6 weeks for those with planned/cesareans, 30.4 weeks for those with unplanned/emergency cesarean and it was 28.9 weeks for vaginally/induced deliveries. Comparison of means indicated significant differences between those who delivered vaginally without induction (p<0.0001) and those with vaginally/induced deliveries and those who with unplanned/cesareans (p=0.03). Conclusion: Mode of delivery may not influence breastfeeding initiation; however, it does appear to impact duration, perhaps indicating a need for additional breast-feeding support for women with assisted deliveries.

Learning Areas:
Other professions or practice related to public health
Program planning

Learning Objectives:
1.) Participants will describe the association between delivery method and breastfeeding from a longitudinal dataset. 2.) Participants will be able to demonstrate the use of findings into program and support services for pregnant and lactating women by providing extra support and assistance to women with assisted deliveries.

Keywords: Breastfeeding, Maternal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present becuase I work on maternal and child health issues and conduct research on topics to promote maternal health
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.