The relationship between caesarean section and breastfeeding: evidence from the 2013 Turkey demographic and health survey

Abstract

Background The mode of delivery influences breastfeeding practices. High caesarean section and low breastfeeding rates are important public health concerns for all developing countries. This study aimed to determine the relationship between caesarean section and early breastfeeding practices among primiparas. Methods Data for primiparas with a singleton birth (n = 777) obtained from the 2013 Turkish Demographic and Health Survey were used in this retrospective cohort study. Early initiation of breastfeeding within one hour of delivery and exclusive breastfeeding during the first three days after delivery were evaluated. Standardized incidence rates and standardized rate ratios of non-early initiation of breastfeeding and non-exclusive breastfeeding were calculated according to mode of delivery. ResultsThe late initiation of breastfeeding and non-exclusive breastfeeding incidence rates were 42.7% and 41.0%, respectively. The standardized incidence rate of late initiation of breastfeeding among women with vaginal delivery was 35.34%, versus 50.49% for those with caesarean delivery. The standardized rate ratios for late initiation of breastfeeding and non-exclusive breastfeeding were 1.428 (95% CI: 1.212, 1.683) and 1.468 (95% CI: 1.236-1.762), respectively.Women that underwent caesarean section had a higher risk of late initiation of breastfeeding and non-exclusive breastfeeding during the three days following delivery, after controlling for sociodemographic and delivery-related factors. Conclusions This study provides evidence useful for implementing strategies to prevent unnecessary caesarean sections, which negatively affect not only maternal health, but also neonatal health as well. Promotion of mother-friendly policies by healthcare institutions that are implemented in a baby-friendly manner are essential.