Associations between caesarean births and breastfeeding in the Middle East: a scoping review

There is a paucity of published studies on factors influencing feeding practices for infants and young children born via caesarean section.

To assess whether the mode of childbirth affects early initiation and exclusive breastfeeding, and to identify factors that positively or negatively influence breastfeeding after caesarean births in selected countries in the Middle East.

We conducted a scoping review of publicly available population-based surveys and peer-reviewed literature on the associations between birthing mode and breastfeeding published between 2000 and 2018. The search identified 33 demographic surveys and 16 studies containing information on the mode of childbirth and breastfeeding in selected countries in the Middle East listed in PubMed, Embase, and CINAHL databases. Searches were completed in March 2019.

Demographic surveys in 6 participating Middle Eastern countries demonstrated increased rates of births by caesarean section. All 3 countries with ≥ 3 datasets available demonstrated that early initiation of breastfeeding was less likely after caesarean section than after vaginal births. Eleven studies analysed differences in breastfeeding outcomes between caesarean section and vaginal births, and all of them identified significant differences between birthing modes. Five studies addressed factors influencing breastfeeding after caesarean births.

Caesarean births are associated with a higher risk of delayed initiation of breastfeeding as well as early cessation of exclusive breastfeeding.