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Abstract

Comparing Breastfeeding Outcomes of Australian Women Who Birth by Elective and Non-Elective Caesarean Section †

by
Lauren Papalia
1,2,
Sarah G. Abelha
3,
Jacki L. McEachran
4,5,6,
Stuart J. Watson
1,2,7,
Linda McKean
1,2,
Stuart A. Prosser
3,4,5,6,
Donna T. Geddes
4,5,6 and
Sharon L. Perrella
4,5,6,*
1
School of Nursing, Curtin University, Bentley, WA 6102, Australia
2
King Edward Memorial Hospital, Subiaco, WA 6008, Australia
3
Western Obstetrics, Balcatta, WA 6021, Australia
4
School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
5
ABREAST Network, Perth, WA 6000, Australia
6
UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
7
Psychology, Murdoch University, Murdoch, WA 6150, Australia
*
Author to whom correspondence should be addressed.
†
Presented at the Australian Breastfeeding + Lactation Research and Science Translation Conference (ABREAST Conference 2023), Perth, Australia, 10 November 2023.
Proceedings 2023, 93(1), 21; https://doi.org/10.3390/proceedings2023093021
Published: 9 January 2024
(This article belongs to the Proceedings of Australian Breastfeeding + Lactation Research and Science Translation Conference 2023)
Versions Notes

Abstract

:
Caesarean section birth (CS) accounts for 38% of Australian births and is known to negatively impact breastfeeding exclusivity and duration. Comparison of breastfeeding outcomes between elective (ELUSCS) and non-elective lower uterine segment caesarean section (NELUSCS) births is needed to inform clinical care. Secondary analysis was performed on data from Australian women who had birthed by CS within the previous 12 months and completed an anonymous online questionnaire. Women responded to items relating to CS birth type and feeding methods immediately post birth, during the hospital stay and in the first 2 weeks at home. Self-reported pain at those time points was rated using a scale of 0–10 with 0 indicating no pain and 10 indicating severe pain. Associations between CS birth type, pain scores and feeding methods were determined, and breastfeeding prevalence at the time of survey completion examined. Our sample consisted of 851 women at 5 ± 3.5 months postpartum, of which 435 (51.1%) were primiparous and 362 (42%) had a NELUSCS birth. Infants born by NELUSCS were more likely to receive formula (37.1% vs. 28.8% ELUSCS, p = 0.024) and less likely to be breastfed (78.6% vs. 85.9% ELUSCS, p = 0.022) during the hospital stay. During the 2 weeks after discharge, women who birthed by NELUSCS had higher mean pain scores (6.5 vs. 4.6 ELUSCS, p < 0.001). Few women expressed and fed their milk in the weeks after discharge, with higher rates seen after NELUSCS (7.7% vs. 3.5%, p = 0.017). Breastfeeding status at study completion was not associated with CS birth type (19.6% ELUSCS vs. 19% NELUSCS, p = 0.99). The study findings indicate that Australian women who give birth by NELUSCS are more likely to experience breastfeeding challenges, with higher rates of infant formula supplementation and a more painful recovery in the days and weeks after birth. In light of the higher postpartum pain scores and lower rates of exclusive breastfeeding, women who birth by NELUSCS need additional postpartum support.

Author Contributions

Conceptualization, S.L.P., S.G.A., S.A.P. and D.T.G.; methodology, S.L.P., S.G.A. and J.L.M.; software, J.L.M.; formal analysis, L.P. and S.J.W.; investigation, S.L.P. and S.G.A.; resources, D.T.G.; data curation, J.L.M.; writing—original draft preparation, L.P.; writing—review and editing, S.L.P., D.T.G. and L.M.; supervision, S.L.P. and L.M.; project administration, L.P. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding. The salaries of D.T.G. and S.L.P. were funded by an unrestricted research grant from Medela AG (Switzerland) and administered by The University of Western Australia. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of Human Research Ethics Committee of The University of Western Australia (approval number: 2022/ET000174 10/08/2023). Reciprocal ethics approval was granted from Curtin University Human Research Ethics Office (approval number: HRE2023-0505, approval date 07/09/2023).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Acknowledgments

We thank all of our participants for their time and help with this research.

Conflicts of Interest

D.T.G. declares participation in the Scientific Advisory Board of Medela AG. D.T.G. and S.L.P. are supported by an unrestricted research grant from Medela AG, administered by The University of Western Australia. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. All other authors declare no conflicts of interest.
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Share and Cite

MDPI and ACS Style

Papalia, L.; Abelha, S.G.; McEachran, J.L.; Watson, S.J.; McKean, L.; Prosser, S.A.; Geddes, D.T.; Perrella, S.L. Comparing Breastfeeding Outcomes of Australian Women Who Birth by Elective and Non-Elective Caesarean Section. Proceedings 2023, 93, 21. https://doi.org/10.3390/proceedings2023093021

AMA Style

Papalia L, Abelha SG, McEachran JL, Watson SJ, McKean L, Prosser SA, Geddes DT, Perrella SL. Comparing Breastfeeding Outcomes of Australian Women Who Birth by Elective and Non-Elective Caesarean Section. Proceedings. 2023; 93(1):21. https://doi.org/10.3390/proceedings2023093021

Chicago/Turabian Style

Papalia, Lauren, Sarah G. Abelha, Jacki L. McEachran, Stuart J. Watson, Linda McKean, Stuart A. Prosser, Donna T. Geddes, and Sharon L. Perrella. 2023. "Comparing Breastfeeding Outcomes of Australian Women Who Birth by Elective and Non-Elective Caesarean Section" Proceedings 93, no. 1: 21. https://doi.org/10.3390/proceedings2023093021

APA Style

Papalia, L., Abelha, S. G., McEachran, J. L., Watson, S. J., McKean, L., Prosser, S. A., Geddes, D. T., & Perrella, S. L. (2023). Comparing Breastfeeding Outcomes of Australian Women Who Birth by Elective and Non-Elective Caesarean Section. Proceedings, 93(1), 21. https://doi.org/10.3390/proceedings2023093021

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