The Association between Cesarean Delivery on Maternal Request and Method of Newborn Feeding in China

Abstract

BackgroundCesarean delivery has increased significantly during the last decades. This study aimed to investigate the association between planned mode of delivery and method of feeding.Methodology/Principal FindingsA cohort was created retrospectively using data from a population-based maternal and child health surveillance system, which covers 27 study sites in China from 1993 to 2006. The cohort consisted of 431,704 women for analysis, including 22,462 women with planned cesarean delivery on maternal request (CDMR) and 409,242 women with planned vaginal delivery (VD). Logistic regression models were used to examine the association between mode of delivery and method of feeding adjusting for selected covariates. In this cohort, 398,176 (92.2%) women exclusively breastfed their baby, 28,798 (6.7%) women chose mixed feeding, and 4,730 (1.1%) women chose formula feeding before hospital discharge. Women who planned CDMR were less likely to exclusively breastfeed and more likely to formula feed their babies than those who planned VD. After adjusting for covariates, the odds ratios were 0.85 (95% CI: 0.81–0.89) for exclusive breastfeeding and 1.61 (95% CI: 1.45–1.79) for formula feeding. Associations between planned mode of delivery and method of feeding in the south, north, rural and urban areas yielded similar results.ConclusionThis study demonstrated that planned CDMR was associated with a lower rate of exclusive breastfeeding and a higher rate of formula feeding in a low-risk Chinese population.

Increasing prevalence of asthma and allergy in Beijing pre-school children: Is exclusive breastfeeding for more than 6 months protective?

“…Traffic-related air pollution has been found to be associated with the development of asthma and allergies during the first 8 years of life [52,56]. Another possible contributory factor is the increased percentage of births by Cesarean delivery in China [57], which may be associated with increased risk of asthma and allergy rates [58].…”

Barriers to Breast Feeding: A Review

“…Maternal issues include mother's age, marital status, occupation, parity, educational level, social and/or health status, multiple pregnancy, mode of delivery, perception of insufficient milk supply (6)(7)(8)(9)(10)(13)(14)(15), and problems related to the feeding process, for example inefficient 'latch', nipple pain etc. (13).…”

“…Some observational studies dealing with maternal factors affecting initiation and continuation of breast feeding revealed that mother's age, education or parity did not affect the rate of breast feeding (10), while others noticed that older age, higher maternal education and multi-parity were associated with higher likelihood of breast feeding at 6 months of age (6)(7)(8). On the other hand, maternal employment, cesarean delivery and infant hospitalization are recognized risk factors for early discontinuation of EBF (10,14,15,25).…”

Cesarean on request

“…The average gestational age is significantly lower in the group of cesarean delivery with no indication as compared to the planned vaginal delivery group in four of the five studies evaluating this outcome (Table 4) (B). [3][4][5][6]9 The mean birth weight is assessed in five studies, and in one work, only the mean weight is significantly higher in the cesarean group without indication (Table 5) (B). [3][4][5][6]8 Effect of cesarean section on maternal request or without indication on maternal mortality Three studies evaluate maternal mortality (B); 2-4 however, only one study has events for this outcome (B).…”

“…The studies (B) 5,9 assessed the association between cesarean section on maternal request or without indication and complications in breastfeeding. The simple average of all the studies revealed that the rate of breastfeeding complications in the group of cesarean delivery on maternal request is 8.4 versus 7.4% in the group of planned vaginal delivery.…”