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. 2023 Dec 7:7:38.
doi: 10.18332/ejm/173089. eCollection 2023.

Breastfeeding among parous women offered home-visit by a midwife after early discharge following planned cesarean section: Secondary analysis of a randomized controlled trial

Anne R Kruse  1   2   3 , Finn F Lauszus  1 , Axel Forman  2   3 , Ulrik S Kesmodel  4   5 , Marie B Rugaard  6 , Randi K Knud-En  6 , Eva-Kristina Persson  7 , Iben B Sundtoft  1   3 , Niels Uldbjerg  2   3
Affiliations

Breastfeeding among parous women offered home-visit by a midwife after early discharge following planned cesarean section: Secondary analysis of a randomized controlled trial

Anne R Kruse et al. Eur J Midwifery. .

Abstract

Introduction: Early discharge holds several advantages and seems safe after planned cesarean section among low-risk women. However, breastfeeding rates are lower after cesarean section. Thus, concern has been raised that early discharge among these women may affect breastfeeding even further. Therefore, we aimed to assess the effect of early discharge the day after planned cesarean section on breastfeeding, among parous women when a home-visit by a midwife was provided the day after discharge.

Methods: We conducted a secondary analysis of a randomized trial. Parous women (n=143) planned for cesarean section were allocated to either discharge within 28 hours after planned cesarean section followed by a home visit the day after (early discharge) or discharge at least 48 hours after planned cesarean section (standard care). The participants filled in questionnaires approximately 2 weeks before delivery and 1 week, 4 weeks, and 6 months postpartum.

Results: The proportions of women initiating breastfeeding were 84% versus 87% (early discharge vs standard care). After 6 months, 23% versus 21% were exclusively breastfeeding, while 29% versus 42% were partially breastfeeding. The mean duration of exclusive breastfeeding was 3.4 months (SD=2.3) in both groups. None of these differences was statistically significant. In both groups, the women's breastfeeding self-efficacy score before cesarean section correlated with the duration of breastfeeding. After 4 weeks, low-score rates were 28% versus 30%.

Conclusions: Early discharge with follow-up home visits by a midwife after planned cesarean section in parous women is feasible without compromising breastfeeding.

Keywords: breastfeeding; cesarean section; house calls; length of stay; postnatal care; self-efficacy.

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Conflict of interest statement

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

Figures

Figure 1
Figure 1
Any breastfeeding after planned cesarean section among women randomized for early discharge or standard care, Denmark, 2016–2019 (N=118)
Figure 2
Figure 2
Exclusive breastfeeding after planned cesarean section among women randomized for early discharge or standard care, Denmark, 2016–2019 (N=118)
See this image and copyright information in PMC

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