Show Kyaw Lwin, Jampathong Nampet, Aung Pyae Linn, Win Kyawt Mon, Ngamjarus Chetta, Pattanittum Porjai, Maung Thae Maung, Tin Khaing Nwe, Myat Su Mon, Bohren Meghan A, Chairunnisa Nogati, Lumbiganon Pisake
Department of Medical Research, Yangon, Myanmar.
Cochrane Thailand, Khon Kaen University, Khon Kaen, Thailand.
BMC Pregnancy Childbirth. 2024 Dec 19;24(1):822. doi: 10.1186/s12884-024-07024-7.
The effect of caesarean section (CS) on breastfeeding initiation has been extensively studied, but its influence on exclusive breastfeeding practices remains inconclusive. Therefore, this study aims to investigate the impact of CS on exclusive breastfeeding using evidence from four countries in the Southeast Asian region.
This cross-sectional study used secondary data obtained from the Demographic and Health Surveys (DHS) conducted between 2016 and 2022 in four countries within the Southeast Asian Region. We included information on the youngest children aged 0-5 months living with their mothers within the DHS datasets. The association between CS and exclusive breastfeeding was determined using a simple and multiple logistic regression models. Weight factors were taken into account in all analyses for the two-stage stratified cluster sampling design.
Among 3420 children, nearly half (49.1%, 95%CI: 47.0, 51.2) were exclusively breastfed. Children born by CS had lower odds of being exclusively breastfed, compared to children born vaginally (aOR = 0.68, 95%CI: 0.53, 0.88). Women who were married or living with a partner (aOR = 2.19, 95%CI: 1.33, 3.60), children born at a health facility (aOR = 1.31, 95%CI: 1.00, 1.71), and girl babies (aOR = 1.24, 95%CI: 1.05, 1.48) had higher odds of exclusive breastfeeding. Furthermore, residing in rural areas was associated with an increased likelihood of exclusive breastfeeding (aOR = 1.47, 95%CI: 1.20, 1.80). Maternal age, mother's education, parity, antenatal and postnatal care taken, and mass media exposure were not associated with exclusive breastfeeding.
This study highlights a significant association between CS and reduced exclusive breastfeeding practices. The findings underscore the importance of providing adequate support and interventions to mothers who deliver by CS and their family members to ensure they can successfully achieve exclusive breastfeeding, particularly in a global context where CS rates are rising.
剖宫产对母乳喂养启动的影响已得到广泛研究，但其对纯母乳喂养行为的影响仍无定论。因此，本研究旨在利用东南亚地区四个国家的证据，调查剖宫产对纯母乳喂养的影响。
本横断面研究使用了2016年至2022年期间在东南亚地区四个国家进行的人口与健康调查（DHS）获得的二手数据。我们纳入了DHS数据集中与母亲同住的0至5个月大的最小儿童的信息。使用简单和多元逻辑回归模型确定剖宫产与纯母乳喂养之间的关联。在所有分析中都考虑了两阶段分层整群抽样设计的权重因素。
在3420名儿童中，近一半（49.1%，95%CI：47.0，51.2）进行了纯母乳喂养。与阴道分娩的儿童相比，剖宫产出生的儿童纯母乳喂养的几率较低（调整后的优势比[aOR]=0.68，95%CI：0.53，0.88）。已婚或与伴侣同住的女性（aOR=2.19，95%CI：1.33，3.60）、在医疗机构出生的儿童（aOR=1.31，95%CI：1.00，1.71）以及女婴（aOR=1.24，95%CI：1.05，1.48）纯母乳喂养的几率较高。此外，居住在农村地区与纯母乳喂养的可能性增加有关（aOR=1.47，95%CI：1.20，1.80）。产妇年龄、母亲教育程度、产次、接受的产前和产后护理以及接触大众媒体与纯母乳喂养无关。
本研究强调了剖宫产与纯母乳喂养行为减少之间的显著关联。研究结果强调了为剖宫产母亲及其家庭成员提供充分支持和干预措施的重要性，以确保她们能够成功实现纯母乳喂养，特别是在剖宫产率不断上升的全球背景下。
