[Prospective observational study on the effects of caesarean section on breastfeeding].
OBJECTIVE
To study the effects of caesarean section on breastfeeding.


METHODS
Six hundred and two [301 cases was caesarean section (caesarean section group) and 301 cases was vaginal delivery (vaginal delivery group)] nulliparas were interviewed face-to-face at antepartum and postpartum in an indication-matched prospective study.


RESULTS
There was a significantly lower postpartum prolactin (PRL) level in the caesarean section group (8.48 nmol/L, 95% CI: 7.80 - 9.21 nmol/L) compared with vaginal delivery group (9.61 nmol/L, 95% CI: 8.99 - 10.26 nmol/L) during 6 - 24 hours in the daytime after delivery. The median time of breastfeeding initiation was 12 hours and 2 hours after birth for caesarean section and vaginal delivery groups respectively. Caesarean section was an important hazard for a shorter duration of breastfeeding (RR = 1.21; 95% CI: 1.10 - 1.33) within one year after childbirth.


CONCLUSIONS
Caesarean section is associated with significantly lower postpartum PRL, which is in line with the longer breastfeeding initiation and lower rate of successful breastfeeding. Necessary measures including promoting the secretion of postpartum PRL such as early contact, early sucking and analgesic method should be taken to improve the successful breastfeeding rate.
Wang
Bing-shun
BS
Department of Biostatistics, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
Zhou
Li-feng
LF
Zhu
Li-ping
LP
Gao
Xiao-ling
XL
Gao
Er-sheng
ES
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000009:adverse effects*; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000502:physiology; D011181:Postnatal Care / Q000379:methods / Q000706:statistics & numerical data; D011247:Pregnancy; D011388:Prolactin / Q000097:blood* / Q000378:metabolism; D011446:Prospective Studies; D011863:Radioimmunoassay; D013997:Time Factors
D011388:Prolactin