Online Program

Impact of smoking status and repeat cesarean section on breastfeeding duration

Sunday, November 1, 2015

Jordyn Wallenborn, MPH, Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA
Saba Masho, MD, MPH, DrPH, Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA
background: The rate of breastfeeding duration is staggeringly low with only half of infants being exclusively breastfed at six months. In recent years, mode of delivery has been identified as one of the risk factors for a shorter duration of breastfeeding. However, there is limited literature examining the impact of repeat C-Section on breastfeeding duration.

methods: 2004-2011 data from the Pregnancy Assessment Monitoring System (PRAMS) was analyzed. Breastfeeding duration (outcome) was based on the survey item, “How many weeks or months did you breastfeed or pump milk to feed your baby?”. Repeat C-Section (exposure) was based on the survey item, “How was your new baby delivered, vaginally or by Cesarean delivery?” and if they had a previous C-Section. Multiple logistic regression was used to determine the effect of repeat C-Section on breastfeeding duration.

results: Women who smoke and have a repeat C-Section had 6-times higher odds of (AOR=6.15, 95% CI= 1.98-19.14) breastfeeding for 8 weeks or less and a 4-times higher odds of never breastfeeding (AOR=4.01, 95% CI= 1.55-10.41) compared to women who give birth by VBAC. Among non-smokers, no association was observed for breastfeeding 8 weeks or less  (AOR=1.35, 95% CI=0.92-1.99) and the association for never breastfeeding diminished (AOR=1.97, 95% CI=1.29-3.02).

conclusions: The results suggest that repeat C-Section negatively affects breastfeeding duration. In addition, smoking women who had repeat C-Section were more likely to never breastfeed or breastfeed for a shorter amount of time. Interventions are needed for mothers who smoke and undergo repeat C-Section.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain why breastfeeding outcomes differ between vaginal birth after Cesarean Section and repeat Cesarean Section. Discuss the inter-relationship between repeat Cesarean Section, smoking status and breastfeeding duration.

Keyword(s): Breastfeeding, Tobacco Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PHD student and research assistant for the Division of Epidemiology at Virginia Commonwealth University with a focus on maternal and child health. I have experience with various child health-related projects in North Dakota as well as recent research on an array of maternal and child health topics. Investigating factors associated with breastfeeding outcomes has been among my scientific interests.
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.