Cesarean section and breastfeeding outcomes in an Indigenous Qom community with high breastfeeding support

Abstract

Background and objectives Cesarean section may lead to suboptimal breastfeeding outcomes, though evidence has been mixed. Factors such as premature birth, birthweight, and maternal age may independently increase risk of cesarean and hinder breastfeeding initiation, while maternal preferences, support, and sociostructural barriers may influence breastfeeding practices beyond the immediate postpartum period. Methodology We assessed impacts of cesarean section and gestational factors on breastfeeding duration among Indigenous Qom mothers in Argentina who have strong traditional breastfeeding support. We modeled transitions from exclusive breastfeeding to complementary feeding and from complementary feeding to full weaning in a Bayesian time-to-event framework with birth mode and gestational covariates (n = 89 infants). Results Estimated median time to full weaning was 30 months. Cesarean-delivered babies were weaned an average of 5 months later adjusting for gestational age, maternal parity, and infant sex. No factors were associated with time to complementary feeding, and time-to-complementary feeding was not associated with time to full weaning. Conclusions and implications Among Indigenous Qom mothers in Argentina, cesarean section was not associated with suboptimal breastfeeding outcomes. Although some Qom mothers do experience early breastfeeding problems, particularly following first birth, problems are not more frequent following cesarean delivery. Traditional postpartum kin and community support during prolonged postpartum periods may be instrumental in helping mothers to overcome early breastfeeding problems due to cesarean or other risk factors. Lay summary We examined associations between cesarean section and breastfeeding transitions among Indigenous mothers in Argentina. Mothers delivering via cesarean section did not introduce complementary foods earlier, and conversely weaned later than mothers who delivered vaginally. Postpartum kin support typical of traditional birthing practices may help mothers overcome early breastfeeding problems.

Prevalence of breastfeeding among indigenous peoples of the Triple Frontier: Brazil, Argentina and Paraguay

“…11 Weaning in certain indigenous populations can occur in a period of less than two years, with an average of 11.4 months, 17 while in others, it occurs around 30 months of age. 12 The deficit in complementary feeding in childhood was detected in the present study, with the continuity of EBF after the sixth month of life until the twenty-fourth month in about one-third of children (28.3%). It is denoted that complementary feeding in most of these populations is compromised, with low food diversity and a significant portion of indigenous children do not receive the minimum acceptable daily food intake.…”

“…A 93.4% prevalence of EBF in the first six months of life and 6.5% of complementary breastfeeding was detected, in agreement with the EBF profile practiced by certain indigenous peoples such as the Nam Qom in Argentina. 12 However, lower prevalence of EBF up to six months is reported in the indigenous population of Ecuador (54.4-78.2%), 11,13 Canada (57.9%), 14 and in the Brazilian Western Amazon (35.0%).…”

“…11 Regarding the route of childbirth, there is divergence among studies, with the identification of late initiation of EB in women who underwent a cesarean section compared to women who had vaginal delivery; and greater use of milk formulas, 15 while in other studies it is reported that cesarean section does not influence EB in indigenous women. 12,15 It is also reported that ethnicity can influence early weaning. 17 deficit (SD) among those who do not receive the minimum amount of daily meals.…”

“…15 In Brazil, complementary breastfeeding in indigenous people was 53.7% in the period from 6 to 12 months and 41.8% from 12-24 months. 21 It is detected that complementary feeding begins at an average of 23 weeks, 12 and the continuity of breastfeeding in children 6-12 months can reach 99.3%. 11 Weaning in certain indigenous populations can occur in a period of less than two years, with an average of 11.4 months, 17 while in others, it occurs around 30 months of age.…”

Prevalência do aleitamento materno entre povos Indígenas da Tríplice Fronteira: Brasil, Argentina e Paraguai

“…Detectou-se nos primeiros seis meses de vida a prevalência do AME de 93,4% e o aleitamento materno complementado de 6,5%, em consonância com o perfil de AME praticado por determinados povos indígenas como os Nam Qom na Argentina. 12 Entretanto, são relatadas menores prevalências de AME até os seis meses na população indígena do Equador (54,4-78,2%), 11,13 Canadá (57,9%), 14 e na Amazônia Ocidental Brasileira (35,0%).…”