title: A prospective study of the effect of delivery type on neonatal weight gain pattern in exclusively breastfed neonates born in Shiraz, Iran.
abstract: BACKGROUND
  In this exploratory study, the contribution of delivery type to the weight gain pattern for full-term infants with exclusive breastfeeding in the first month of infancy was determined. In addition, breastfeeding success among cesarean section (C-section) delivery mothers based on their neonate's weight gain at the end of the first month of infancy was evaluated.
  
  
  METHODS
  A cohort of 92 neonates born in Shiraz, from July 10 to August 10, 2007 was followed longitudinally. The data were collected during the first month postpartum at three occasions: 3 to 7 days postpartum, 10-21 days postpartum and 24-31 days postpartum.
  
  
  RESULTS
  Among 92 mothers in this study, 35 (38%) were delivered by C-section. Generalized estimating equation (GEE) showed that delivery type (p < 0.01), receipt of advice about breastfeeding (p = 0.03) and neonate's age (p < 0.01) significantly affected weight gain. GEE estimated the values of the parameters under study and the testing contribution of each factor to weight gain, leading to the conclusion that gender, parities and maternal education did not contribute to weight gain. The neonate's weight gain pattern for C-section deliveries lies below that of normal vaginal deliveries until 25 days postpartum, when weight gain for C-section deliveries became higher than that for normal vaginal deliveries.
  
  
  CONCLUSIONS
  Type of delivery contributes strongly to the weight gain pattern in the first month of infancy. In spite of greater weight loss among C-section birth neonates in the first days of life, at the end of the first month neonates showed a similar weight gain. Consequently, mothers with C-section delivery can successfully exclusively breastfeed.
authors.affiliation: Department of Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University/Medical Sciences, Tehran, Iran. eshraghianmr@yahoo.com.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Saki
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Eshraghian
authors.forename: Kazem
authors.initials: K
authors.lastname: Mohammad
authors.forename: Abbas Rahimi
authors.initials: AR
authors.lastname: Foroushani
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Bordbar