Influences of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study

J Hum Lact. 2018 Aug;34(3):526-534. doi: 10.1177/0890334417741434. Epub 2018 Jan 24.


Background: Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration.

Methods: This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother-infant pairs in three communities in Hunan, China. Data about participants' characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant's birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery.

Results: The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p < .05). In addition, cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]).

Conclusion: Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

Keywords: breastfeeding; breastfeeding duration; breastfeeding initiation; breastfeeding practices; cesarean section; infant formula.

MeSH terms

  • Adult
  • Breast Feeding / methods*
  • Breast Feeding / statistics & numerical data
  • Cesarean Section / adverse effects*
  • Cesarean Section / methods
  • Cesarean Section / rehabilitation
  • Chi-Square Distribution
  • China
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Prospective Studies
  • Time Factors*