Breastfeeding Success After Vaginal Delivery Versus Scheduled Cesarean Section [21F

Abstract

INTRODUCTION: The objective of this study is to identify how labor affects initiation and effectiveness of breastfeeding postpartum. METHODS: This is a retrospective cohort study of breastfeeding success after vaginal delivery, cesarean section after labor, and scheduled cesarean section in term, singleton deliveries in nulliparous patients at a large academic institution from 2017-2018. Breastfeeding success in the immediate postpartum period was measured by the presence of breastfeeding, the need for formula supplementation, and the neonatal percentage in weight loss over the first 2-3 days of life. This study was approved by the IRB at the Icahn School of Medicine at Mount Sinai. RESULTS: A total of 500 women met inclusion criteria during the study period, 339 (68%) of whom underwent spontaneous vaginal delivery (SVD), 71 (14%) of whom underwent cesarean section after labor, and 90 (18%) of whom delivered by scheduled cesarean section. Women who underwent SVD were more likely to have decreased need for formula supplementation in comparison to women who delivered via cesarean section in labor or scheduled cesarean section (57.7% vs. 75.4% and 78.5%, p<0.05), require fewer number of daily formula feedings on average (1.8+2.3 vs. 2.3+2.2 and 2.7+2.6, p<0.05), and experience a smaller percentage in neonatal weight loss over the first 2-3 days of life (4.9+2.0 vs. 7.1+2.3 and 6.4+2.8, p<0.05). CONCLUSION: Women who deliver by cesarean section may need more support to maintain exclusive breastfeeding postpartum than patients after vaginal delivery.