Department of Pediatrics, Padua University School of Medicine, Via Giustiniani, 3 35128 Padua, Italy.
Birth. 2010 Dec;37(4):275-9. doi: 10.1111/j.1523-536X.2010.00421.x.
Cesarean delivery has negative effects on breastfeeding. The objective of this study was to evaluate breastfeeding rates, defined in accordance with World Health Organization guidelines, from delivery to 6 months postpartum in infants born by elective and emergency cesarean section and in infants born vaginally.
Delivery modalities were assessed in relation to breastfeeding patterns in 2,137 term infants delivered at a tertiary center, the Padua University School of Medicine in northeastern Italy, from January to December 2007. The study population included 677 (31.1%) newborns delivered by cesarean section, 398 (18.3%) by elective cesarean, 279 (12.8%) by emergency cesarean section, and 1,496 (68.8%) delivered vaginally.
Breastfeeding prevalence in the delivery room was significantly higher after vaginal delivery compared with that after cesarean delivery (71.5% vs 3.5%, p < 0.001), and a longer interval occurred between birth and first breastfeeding in the newborns delivered by cesarean section (mean ± SD, hours, 3.1 ± 5 vs 10.4 ± 9, p < 0.05). No difference was found in breastfeeding rates between the elective and emergency cesarean groups. Compared with elective cesarean delivery, vaginal delivery was associated with a higher breastfeeding rate at discharge and at the subsequent follow-up steps (7 days, 3 mo, and 6 mo of life).
Emergency and elective cesarean deliveries are similarly associated with a decreased rate of exclusive breastfeeding compared with vaginal delivery. The inability of women who have undergone a cesarean section to breastfeed comfortably in the delivery room and in the immediate postpartum period seems to be the most likely explanation for this association.
剖宫产对母乳喂养有负面影响。本研究的目的是评估根据世界卫生组织指南定义的婴儿从分娩到产后 6 个月的母乳喂养率，包括择期和紧急剖宫产分娩以及阴道分娩的婴儿。
2007 年 1 月至 12 月，在意大利东北部帕多瓦大学医学院的一家三级中心，评估了 2137 例足月分娩婴儿的分娩方式与母乳喂养模式之间的关系。研究人群包括 677 例（31.1%）剖宫产分娩新生儿、398 例（18.3%）择期剖宫产分娩、279 例（12.8%）紧急剖宫产分娩和 1496 例（68.8%）阴道分娩。
阴道分娩时新生儿在产房的母乳喂养率明显高于剖宫产（71.5% vs. 3.5%，p<0.001），剖宫产新生儿出生至首次母乳喂养的时间间隔较长（平均±标准差，小时，3.1±5 vs. 10.4±9，p<0.05）。择期和紧急剖宫产组的母乳喂养率无差异。与择期剖宫产分娩相比，阴道分娩与更高的产后和后续随访时母乳喂养率相关（7 天、3 个月和 6 个月）。
与阴道分娩相比，紧急和择期剖宫产分娩与纯母乳喂养率降低相关。行剖宫产的妇女在产房和产后即刻期间不能舒适地进行母乳喂养，这似乎是导致这种关联的最可能原因。
