title: Effect of delivery method and timing of breastfeeding initiation on breastfeeding outcomes in Taiwan.
abstract: BACKGROUND
  Few studies have examined the independent effect of delivery method and timing of breastfeeding initiation on the prevalence of breastfeeding. The objectives of this study were to examine the effect of method of delivery and timing of breastfeeding initiation on the prevalence of breastfeeding at 1 and 3 months after delivery using a national sample from Taiwan.
  
  
  METHODS
  The study population of 2,064 women who gave birth to infants without congenital anomalies at hospitals in Taiwan from June through October 2003, inclusively, participated in a postal questionnaire survey.
  
  
  RESULTS
  Multivariate ordinal logistic regression analysis showed that women with cesarean delivery had a lower odds of breastfeeding at 1 and 3 months after delivery. Women with assisted vaginal delivery had lower odds of breastfeeding at 3 months after delivery compared with women with unassisted vaginal delivery. Initiation of breastfeeding within 30 minutes of delivery was associated with higher odds of breastfeeding at 1 and 3 months after delivery. Women who did not initiate breastfeeding during hospital stay but breastfed at 1 month after delivery had lower odds of breastfeeding at 3 months after delivery.
  
  
  CONCLUSIONS
  The findings suggest the importance of conservative use of operative obstetrical intervention due to its negative impact on breastfeeding. Health professionals need to support mothers who have experienced cesarean and assisted vaginal delivery to increase their breastfeeding. Hospital staff should improve practice with respect to early initiation of breastfeeding.
authors.affiliation: Institute of Clinical and Community Health Nursing, National Yang-Ming University, and Department of Traditional Chinese Medicine, Taipei Medical University Hospital, Taiwan.
authors.forename: Li-Yin
authors.initials: LY
authors.lastname: Chien
authors.forename: Chen-Jei
authors.initials: CJ
authors.lastname: Tai
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D003466:Cultural Characteristics; D036861:Delivery, Obstetric / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008425:Maternal Behavior; D009034:Mother-Child Relations; D017063:Outcome Assessment, Health Care; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D012189:Retrospective Studies; D012944:Social Support; D013624:Taiwan / Q000453:epidemiology