ISSN: 2454-2342 (online), 2454-2334 (print)
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The New Indian Journal of OBGYN. 10(1):158-166

Comparative evaluation of early postpartum breast feeding patterns in women undergoing caesarean section and vaginal delivery

Aparna Nair, Sampath Kumar, Abhirami GR, Sridhar Venkatesh, Usha Rani

ABSTRACT

Objective: This study is a comparative evaluation of early postpartum breast feeding patterns among women undergoing caesarean section & vaginal delivery. Also to study factors affecting initiation of breast feeding in both the group of women. Methods: This was a prospective comparative observational study for 6 monthswhich included 314 women. Women who fulfilled inclusion criteria were 236 mothers – infant pairs. Early initiation was defined as breastfeeding within 1 hour of delivery. Mode and time of delivery and initiation of breast feeding within 1 hr of delivery observed and noted. On Day 3 breast feeding was assessed for positioning, latching, suckling and comfort. The relationship between mode of delivery and various aspects breast feeding was analysed based on the direct interview conducted on postnatal day 1 and 3. Results: Amongst the 236 women - 148 (62.7%) delivered vaginally and 88 delivered (37.35%) by caesarean section. Early initiation of breast feeding in vaginal delivery and caesarean section were 70.3% and 27.3% respectively (p<0.001). Successful establishment of breast feeding on D3 was 86.5% and 39.8% in vaginal delivery and caesarean section respectively (p<0.001). Those who initiated breast feeding within 1hr of delivery, all of them established comfortable breast feeding by D3 (n=128; 100%), whereas those who did not breastfeed within 1hr only 32.4%(n=35) established comfortable breast feeding pattern by D3(p=0.001). Upper middle SES class, previous lactation history of more than 6 months, booked case, normal duration of labour (5-9 hours) and presence of female attender were positively correlated to early initiation of breast feeding and established breast feeding on D3. Post-delivery pain, improper latching, inadequate milk production and flat nipple were significantly more in women undergoing caesarean section. Conclusion: Caesarean section is associated with late initiation of breast feeding and they did not have established breast feeding even on day 3. Increasing percentage of vaginal birth after caesarean section and aggressive counselling regarding benefits of breast feeding could positively increase early initiation of breast feeding, leading to various long term benefits.

doi: 10.21276/obgyn.2023.10.1.28 Full Text PDF
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