title: The effect of delivery method on breastfeeding initiation from the The Ontario Mother and Infant Study (TOMIS) III.
abstract: OBJECTIVE
  To report on the relationship between delivery method (cesarean vs. vaginal) and type (planned vs. unplanned) and breastfeeding initiation in hospital and continuation to 6 weeks postpartum as self-reported by study participants.
  
  
  METHODS
  Quantitative sequential mixed methods design.
  
  
  METHODS
  Women were recruited from 11 hospital sites in Ontario, Canada.
  
  
  METHODS
  Participants included 2,560 women age 16 years or older who delivered live, full-term, singleton infants.
  
  
  METHODS
  Data were collected from an in-hospital questionnaire, hospital records, and a 6-week postpartum interview.
  
  
  RESULTS
  Ninety-two percent of women reported initiating breastfeeding, and 74% continued to 6 weeks. The method of delivery, when defined as cesarean versus vaginal, was not a determining factor in breastfeeding initiation in hospital or in the early postdischarge period. An unexpected delivery method (i.e., unplanned cesarean or instrument-assisted vaginal deliveries) was associated, at a statistically significant level, with an increased likelihood of initiating breastfeeding and continuation to 6 weeks postdischarge.
  
  
  CONCLUSIONS
  Breastfeeding can be considered a coping strategy that serves to normalize an abnormal experience and allows the individual to once again assume control. These unexpected results warrant further investigation to understand why women make the decision to initiate breastfeeding, why they choose to continue breastfeeding, and how they can be supported to achieve exclusive breastfeeding as recommended for infants in the first 6 months.
authors: School of Social Work, McMaster University, Hamilton, ON, Canada. wattms@mcmaster.ca
authors: Susan
authors: S
authors: Watt
authors: Wendy
authors: W
authors: Sword
authors: Debbie
authors: D
authors: Sheehan
authors: Gary
authors: G
authors: Foster
authors: Lehana
authors: L
authors: Thabane
authors: Paul
authors: P
authors: Krueger
authors: Christine Kurtz
authors: CK
authors: Landy
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005865:Gestational Age; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007229:Infant Welfare; D007231:Infant, Newborn; D008297:Male; D009034:Mother-Child Relations; D009864:Ontario; D049590:Postpartum Period / Q000502:physiology; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D047929:Term Birth; D013997:Time Factors; D055815:Young Adult