PD.02 Intervention in labour and early breastfeeding outcomes

Abstract

Background Breastfeeding is the optimal nutrition for babies, and its successful initiation is one of the aims of maternity care. This paper explores the association between aspects of intrapartum care and early breastfeeding problems. Methods Analysis of routinely-collected data on all births in Victoria, Australia in 2009. Comparison of proportions and multivariate logistic regression were performed. Results Of the 69,143 women who gave birth to term, liveborn babies, 96.3% initiated breastfeeding. 77.8% of the women who initiated breastfeeding gave the last feed before discharge entirely and directly from the breast. Women who experienced a number of interventions in labour and birth were more likely than others to have a problem with this. Oxytocin infusions to induce or augment labour (Relative Risk (RR) 1.26, 95% CI 1.2, 1.3), epidural analgesia (RR 1.36, 95% CI 1.3, 1.4), and caesarean section (RR 1.58, 95% CI 1.5, 1.6) were all associated with giving some expressed breastmilk or formula at the last feed before discharge. Term, breastfed babies whose mothers experienced these interventions were more likely to be given infant formula in hospital (oxytocin infusions (RR 1.18, 95% CI 1.1, 1.2), epidural analgesia (RR 1.30, 95% CI 1.26, 1.34), and caesarean section (RR 1.70, 95% CI 1.65, 1.75)). These relationships persisted after adjustment for parity, maternal BMI, age, public/private admission status, smoking during pregnancy and socio-economic status. Conclusions Common interventions in labour and birth are associated with early breastfeeding problems. Decisions about the risks and benefits of any given intervention should take this into account.

Caesarean section following induction of labour in uncomplicated first births- a population-based cross-sectional analysis of 42,950 births

“…The CS rate in the state of Victoria doubled from 15.3 % in 1985 to 30.6 % in 2006 [ 1 ], and was 32.0 % in 2011 [ 2 ]. Although CS can be life-saving for the mother and/or baby when used judiciously, it also carries risks for: higher rates of maternal morbidity, mortality and delayed recovery from the birth [ 3 , 4 ]; difficulty establishing breastfeeding [ 5 ]; neonatal morbidity and admission to nursery care [ 4 ]; serious placental complications in subsequent pregnancies [ 6 , 7 ]; and increased costs for the health system [ 8 ].…”

Induction of Labour at 40 Weeks May Reduce Likelihood of Caesarean Section

“…With a CS rate of 30.6% in 2006 [1] and 32.0% in 2011 [2], Victoria saw a doubling of its CS rate between 1985 and 2006. Although CS has the potential to save the lives of both the mother and the baby if used appropriately, it also carries risks including but not limited to: increased rates of maternal morbidity, mortality, and delayed recovery from the birth; complexity trying to establish breastfeeding [4]; neonatal mortality and admittance to childcare care [3]; serious placental problems in future pregnancies [5]; increased prices for the health system [6].…”