**3.4 Cesarean birth and the duration of breastfeeding**

As already mentioned, there is scientific evidence showing that a CS can lead to the early discontinuation of breastfeeding [68]. On the other hand, there are earlier studies showing that cesarean birth does not affect the duration of breastfeeding if women initiate breastfeeding from the time point of birth and maintain it for at least four weeks postpartum [69]. In a recent prospective cohort study of 3,021 women in Canada, it was shown that the mode of birth is a significant independent predictor for breastfeeding cessation at or prior to 12 weeks postpartum (p = 0.014). In the adjusted multivariable logistic regression model, women who had a planned CS were more likely to have early cessation of breastfeeding [≤12 weeks] [OR = 1.61; 95%CI: 1.14-2.26; p = 0.006] when compared to those who


<sup>≥</sup>*0.05. <sup>b</sup>*

*<0.05. c <0.001.*

*d Reference group set as vaginal delivery.*

#### **Table 2.**

*Unadjusted and adjusted logistic regression model of mode of delivery on the duration of breastfeeding up to 12-weeks postpartum.*

#### *Cesarean Section and Breastfeeding Outcomes DOI: http://dx.doi.org/10.5772/intechopen.96658*

delivered vaginally. There was no significant difference in breastfeeding cessation between women who had an emergency CS and women who delivered vaginally in the adjusted analysis [42] (**Table 2**).

Another study found that cesarean births were associated with lower rates of exclusive breastfeeding at 6 months, with no difference found between planned versus emergency CS [70].

There is a large systematic review and meta-analysis on breastfeeding outcomes after cesarean birth that included data of 53 studies from 33 different countries. Prior and colleagues (2012) identified lower rates of any breastfeeding and exclusive breastfeeding at 6 months among women who had a cesarean birth (planned or unplanned) when compared with a vaginal birth (normal or instrumental). However, based on a subgroup analysis they found that although cesarean birth was associated with lower rates of initiation, those mothers who did initiate successfully were as likely to exclusively breastfeed at 6 months with those who had a vaginal birth. This important finding suggests that early interventions could be very effective following a cesarean birth in terms of establishing lactation and continuation of breastfeeding for a long period of time [41].
