title: Intraoral Vacuum of Breast-Feeding Newborns Within the First 24 Hr: Cesarean Section Versus Vaginal Delivery.
abstract: To explore whether newborns born via Cesarean section have a weaker intraoral vacuum compared with those born vaginally and to determine whether a weaker intraoral vacuum is related to a delayed onset of lactation.
  
  
  
  For this prospective cohort study, 71 mother-infant dyads were enrolled and divided into birthing groups, vaginal or Cesarean. The newborn intraoral vacuum was measured via a tube placed alongside the nipple and connected to a pressure sensor during a breast-feeding session within the first 24 hr after birth. Onset of lactation was confirmed by maternal perception of breast fullness. The intraoral vacuum and its relationship with the onset of lactation were analyzed.
  
  
  
  After adjustment for confounding factors, the peak intraoral vacuum was -19.50 kPa in the vaginal group, which was significantly stronger than the -13.78 kPa in the Cesarean group (p = .005). Additionally, the baseline intraoral vacuum in the vaginal group (-2.35 kPa) was significantly stronger than that in the Cesarean group (-1.18 kPa; p = .022). Strength of the newborn intraoral vacuum was associated with the time of onset of maternal lactation.
  
  
  
  Cesarean section may weaken newborns' intraoral vacuum within the first 24 hr after birth. Stronger intraoral vacuum was related to earlier onset of lactation. Early intervention aimed at the weaker intraoral vacuum should be provided to promote the onset of lactation.
authors.affiliation: School of Nursing, Fudan University, Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.affiliation: School of Nursing, Fudan University, Shanghai, China hsxia@fudan.edu.cn.
authors.forename: Haiou
authors.initials: H
authors.lastname: Xia
authors.affiliation: School of Nursing, Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.affiliation: Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Qin
authors.affiliation: Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Gu
authors.affiliation: Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Xujuan
authors.initials: X
authors.lastname: Xu
authors.affiliation: Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Meiyun
authors.initials: M
authors.lastname: Shen
mesh_terms: D000328:Adult; D001942:Breast Feeding; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000502:physiology*; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D013391:Sucking Behavior / Q000502:physiology*; D055815:Young Adult
keywords: Cesarean birth; breast-feeding; lactation; vaginal birth