title: [Prospective observational study on the effects of caesarean section on breastfeeding].
abstract: 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.
authors.affiliation: Department of Biostatistics, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
authors.forename: Bing-shun
authors.initials: BS
authors.lastname: Wang
authors.forename: Li-feng
authors.initials: LF
authors.lastname: Zhou
authors.forename: Li-ping
authors.initials: LP
authors.lastname: Zhu
authors.forename: Xiao-ling
authors.initials: XL
authors.lastname: Gao
authors.forename: Er-sheng
authors.initials: ES
authors.lastname: Gao
mesh_terms: 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
chemical_list: D011388:Prolactin