Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Jiangan Maternal and Child Health Hospital, Wuhan, 430014, Hubei, China.
Eur J Clin Nutr. 2018 Dec;72(12):1644-1654. doi: 10.1038/s41430-018-0127-9. Epub 2018 Apr 18.
BACKGROUND/OBJECTIVES: Breastfeeding is of great benefit to infants and their mothers. Caesarean delivery (CD) have increased worldwide in recent years and emerging evidence has implied that CD may influence the initiation and duration of breastfeeding. However, the findings are inconsistent and intricate. The aim of this study is to illuminate the association between the CD and the initiation and duration of breastfeeding in the first 6 months postpartum.
SUBJECTS/METHODS: A total of 2058 mother-infant pairs were studied in this prospective study. Delivery information was obtained from birth records. Feeding information in the first 6 months postpartum were collected from face-to-face interviews. Logistic regression was used to explore the association between CD and the initiation and duration of breastfeeding.
After adjustment for potential confounders, CD was significantly associated with the unsuccessful initiation of breastfeeding [odds ratio (OR): 1.943, 95% confidence interval (CI): 1.050-3.597] and delayed initiation of breastfeeding [OR: 1.450, (95% CI: 1.041-2.019)], when compared with vaginal delivery (VD). More importantly, for mothers who had initiated breastfeeding, CD was associated with significantly higher risks of an inability to sustain full breastfeeding (OR: 1.369, 95% CI: 1.128-1.662), any breastfeeding at 3 months postpartum (OR: 1.715, 95% CI: 1.265-2.325) and any breastfeeding at 6-month postpartum (OR: 1.462, 95% CI: 1.174-1.820).
CD is an independent risk factor for the inability to initiate and sustain breastfeeding. It is desirable to reduce the CD rate and provide specific breastfeeding support during early postpartum period to CD mothers.
背景/目的：母乳喂养对婴儿及其母亲有很大的益处。近年来，全世界剖宫产（CD）的数量有所增加，新出现的证据表明，剖宫产可能会影响母乳喂养的开始和持续时间。然而，研究结果并不一致且复杂。本研究的目的是阐明 CD 与产后 6 个月内母乳喂养开始和持续时间之间的关系。
受试者/方法：本前瞻性研究共纳入了 2058 对母婴对。分娩信息从分娩记录中获得。产后 6 个月内的喂养信息通过面对面访谈收集。使用逻辑回归来探讨 CD 与母乳喂养开始和持续时间之间的关系。
在调整了潜在混杂因素后，与阴道分娩（VD）相比，CD 与母乳喂养开始不成功[比值比（OR）：1.943，95%置信区间（CI）：1.050-3.597]和延迟开始母乳喂养[OR：1.450，（95% CI：1.041-2.019）]显著相关。更重要的是，对于已经开始母乳喂养的母亲，CD 与无法持续完全母乳喂养的风险显著增加相关[OR：1.369，95% CI：1.128-1.662]，3 个月时任何母乳喂养[OR：1.715，95% CI：1.265-2.325]和 6 个月时任何母乳喂养[OR：1.462，95% CI：1.174-1.820]。
CD 是母乳喂养开始和持续的独立危险因素。应降低 CD 率，并在产后早期为 CD 母亲提供特定的母乳喂养支持。
