The article, Implications of Cesarean Delivery for Breastfeeding Outcomes and Strategies to Support Breastfeeding by Kuyper E., Vitta B., and Dewey K., addresses four main issues:

  1. Rapidly rising C-section rates in low– to middle–income countries
  2. Lower breastfeeding initiation rates following C-section than vaginal births
  3. Breastfeeding rates at six months are the same among mothers who initiate breastfeeding irrespective of birth method
  4. Overall breastfeeding rates can improve with interventions to improve breastfeeding initiation rates.

C-section birth when medically indicated, is associated with reduced maternal and neonatal morbidity and mortality. This intervention is a valuable tool that saves lives in obstetrical emergencies. A national C-section birth rate less than 10 percent typically is indicative of unmet obstetric needs. Whereas a rate that exceeds 15 percent of total births, may indicate an excessive use of C-section delivery. C-section rates are increasing in many low- to middle-income countries as well as high-income countries. Globally, C-section birth has significantly increased since 1980. Back in 1980, the C-section rate in the USA was 16.5% and Brazil had a rate of 19%. Currently, the USA rate is greater than 30%, Brazil over 40% and some countries have reached rates as high as 60%.

With the improved access to emergency obstetrical care by trained health professionals, there may also be a trend towards non-medically indicated C-sections along with the “over-medicalization” of childbirth. Understanding that there are lower breastfeeding initiation rates following C-section births, these increasing rates are of concern. It is important to remember though, that those who successfully initiate breastfeeding after C-section birth, have similar rates of exclusive breastfeeding at 6 months, as mothers who birth vaginally.

This article recommends five strategies to improve breastfeeding outcomes post C-section birth which include: adopting supportive hospital policies, training medical staff to support breastfeeding post C-section birth, removing physical barriers to breastfeeding, C-section and breastfeeding education, and reducing non-medically indicated C-section births. To find out more about this interesting article please take the opportunity to completely read Implications of Cesarean Delivery for Breastfeeding Outcomes and Strategies to Support Breastfeeding