The Interrelationship Between Repeat Cesarean Section, Smoking Status, and Breastfeeding Duration
Jordyn T Wallenborn1, Saba W Masho1
1Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University , Richmond, Virginia.
Summary
Repeat cesarean delivery significantly reduces breastfeeding duration, especially for mothers who smoke during pregnancy. Targeted interventions are crucial for this vulnerable group to improve infant feeding outcomes.
Area of Science:
- Reproductive Health
- Maternal-Infant Health
- Public Health
Background:
- Breastfeeding rates in the U.S. remain low, with only 25% of infants exclusively breastfed at 6 months.
- Maternal smoking and delivery mode are known risk factors for reduced breastfeeding duration.
- The impact of repeat cesarean delivery on breastfeeding duration, considering smoking status, requires further investigation.
Purpose of the Study:
- To evaluate the effect of repeat cesarean delivery on breastfeeding duration.
- To analyze the influence of maternal smoking status on this relationship.
Main Methods:
- Analysis of U.S. population-based Pregnancy Risk Assessment Monitoring System (PRAMS) data (2004-2011).
- Inclusion of women with live singleton births, prior cesarean delivery, and available mode of delivery and breastfeeding data.
- Stratified multinomial logistic regression models to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) by smoking status.
Main Results:
- Among smokers, repeat cesarean delivery increased the odds of never breastfeeding (AOR=2.43) and breastfeeding ≤8 weeks (AOR=4.11) compared to vaginal birth after cesarean.
- Among nonsmokers, repeat cesarean delivery increased the odds of never breastfeeding (AOR=2.36) and breastfeeding ≤8 weeks (AOR=1.44) compared to vaginal birth after cesarean.
- The negative impact of repeat cesarean delivery on breastfeeding duration was observed in both smoking and nonsmoking groups, though more pronounced in smokers.
Conclusions:
- Repeat cesarean delivery is associated with significantly shorter breastfeeding duration, particularly among women who smoke during pregnancy.
- Interventions should be developed to support breastfeeding initiation and duration for mothers who smoke and have undergone repeat cesarean deliveries.
- Further research may explore specific barriers and facilitators for breastfeeding in this population.
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