Effect of intrapartum interventions on the timely initiation of breastfeeding

Abstract

Breastfeeding has numerous health benefits to infants and mothers. Early breastfeeding initiation is a determining factor that is associated with increased breastfeeding duration and exclusivity. Reasons for delayed breastfeeding initiation are multifactorial and the results of previous studies are contradictory. The objective of this study was to examine the association between intrapartum interventions and timely breastfeeding initiation. A total of 1240 participants were recruited from four geographically distributed hospitals in Hong Kong. We used cox proportional hazards modelling to assess the association between intrapartum interventions, hospital practices, and birth factors and the time of initiation of breastfeeding. One-half (50.6%) of participants experienced natural birth while 15.5% had a cesarean section. Delayed breastfeeding initiation was noted among the participants who had an assisted vaginal delivery (aHR: 0.74, 95% CI: 0.56-0.97) and cesarean section (aHR: 0.30, 95%CI: 0.25-0.36). Intramuscular pethidine was also associated with delayed breastfeeding (aHR: 0.79, 95% CI: 0.67-0.92) but there was no association between epidural analgesia and breastfeeding initiation. Natural birth was strongly associated with early breastfeeding initiation (aHR=1.75, 95% CI 1.53-2.00). Babies born between 0800 to 1559 hours were also more likely to initiate breastfeeding earlier (aHR: 1.23, 95% CI: 1.06-1.42). Clinicians should focus on providing additional support to new mothers who have had intrapartum pharmacological pain management and operative deliveries. Around the clock breastfeeding support should also be provided in hospitals.