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.
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