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. 2024 Mar 3;21(3):296.
doi: 10.3390/ijerph21030296.

Australian Women's Experiences of Establishing Breastfeeding after Caesarean Birth

Sharon L Perrella  1   2   3 , Sarah G Abelha  1   4 , Philip Vlaskovsky  5 , Jacki L McEachran  1   2   3 , Stuart A Prosser  1   4 , Donna T Geddes  1   2   3
Affiliations

Australian Women's Experiences of Establishing Breastfeeding after Caesarean Birth

Sharon L Perrella et al. Int J Environ Res Public Health. .

Abstract

Breastfeeding exclusivity and duration rates are lower after caesarean birth, yet the factors contributing to these are not well understood. This mixed-methods study used an anonymous online questionnaire to examine the facilitators and barriers to establishing breastfeeding as identified by Australian women after a caesarean birth. Quantitative data were reported using descriptive statistics, and multivariable models were used to determine the factors associated with breastfeeding outcomes including the timing of breastfeeding initiation, birth experience, and commercial infant formula use. Qualitative data were analysed using an inductive thematic analysis. Data were obtained for N = 961 women, of which <50% reported skin-to-skin contact during breastfeeding initiation. The barriers to breastfeeding included aspects of clinical care and reduced mobility, while unrushed care, partner support, and physical help with picking up the baby were helpful. Following a non-elective caesarean birth, women had half the odds of early breastfeeding initiation (OR = 0.50; 95% CI: 0.36, 0.68; p ≤ 0.001) and 10 times the odds to report a negative birth experience (OR = 10.2; 95% CI: 6.88, 15.43; p < 0.001). Commercial milk formula use was higher in primiparous women (OR = 2.16; 95% CI: 1.60, 2.91; p < 0.001) and in those that birthed in a private hospital (OR = 1.67; 95% CI: 1.25, 2.32; p = 0.001). Pain and reduced mobility, as well as conflicting and rushed care, negatively impacted breastfeeding after a caesarean birth, while delayed breastfeeding initiation, higher pain ratings, and negative birth experiences were more common for women that birthed by non-elective caesarean. This study adds valuable insights into the physical, emotional, and clinical care needs of women in establishing breastfeeding after a surgical birth. Clinical staffing and care should be modified to include full access to partner support to meet the specific needs of breastfeeding women after a caesarean birth.

Keywords: birth; breastfeeding; caesarean; lactation; midwifery; postpartum.

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Conflict of interest statement

Authors S.G.A., P.V., and S.A.P declare no conflicts of interest. Authors S.L.P., J.L.M., and D.T.G. receive salaries from an unrestricted research grant that is paid to the University of Western Australia by Medela AG. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study recruitment flow chart.
Figure 2
Figure 2
Women’s experiences of establishing breastfeeding after a caesarean birth.
See this image and copyright information in PMC

References

    1. Thirukumar P., Coates D., Henry A. Women’s experiences of intrapartum care and recovery in relation to planned caesarean sections: An interview study. Women Birth. 2021;34:e248–e254. doi: 10.1016/j.wombi.2020.05.001. - DOI - PubMed
    1. Sandall J., Tribe R.M., Avery L., Mola G., Visser G.H., Homer C.S., Gibbons D., Kelly N.M., Kennedy H.P., Kidanto H., et al. Short-term and long-term effects of caesarean section on the health of women and children. Lancet. 2018;392:1349–1357. doi: 10.1016/S0140-6736(18)31930-5. - DOI - PubMed
    1. Singh J., Scime N.V., Chaput K.H. Association of Caesarean delivery and breastfeeding difficulties during the delivery hospitalization: A community-based cohort of women and full-term infants in Alberta, Canada. Can. J. Public Health. 2023;114:104–112. doi: 10.17269/s41997-022-00666-0. - DOI - PMC - PubMed
    1. Andrew M.S., Selvaratnam R.J., Davies-Tuck M., Howland K., Davey M. The association between intrapartum interventions and immediate and ongoing breastfeeding outcomes: An Australian retrospective population-based cohort study. Int. Breastfeed. J. 2022;17:48. doi: 10.1186/s13006-022-00492-7. - DOI - PMC - PubMed
    1. Li Z., Mannava P., Murray J.C.S., Sobel H.L., Jatobatu A., Calibo A., Tsevelmaa B., Saysanasongkham B., Ogaoga D., Waramin E.J., et al. Association between early essential newborn care and breastfeeding outcomes in eight countries in Asia and the Pacific: A cross-sectional observational-study. BMJ Glob. Health. 2020;5:e002581. doi: 10.1136/bmjgh-2020-002581. - DOI - PMC - PubMed

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