Impact of Delivery Method on Initiation and Continuation of Breastfeeding: A Prospective Cohort Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Ethical Considerations
2.3. Participants
2.4. Sample Size Calculation
2.5. Data Collection and Instruments
2.6. Statistical Analysis
3. Results
4. Discussion
4.1. Mothers’ Demographic Characteristics and Breastfeeding Outcomes
4.2. Breastfeeding Support and Breastfeeding Outcomes
4.3. Method of Delivery and Breastfeeding Outcomes
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
BBAT | Bristol Breastfeeding Assessment Tool |
BMI | Body Mass Index |
BFHI | Baby-Friendly Hospital Initative |
NICU | Neonatal Intensive Care Unit |
WHO | World Health Organization |
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Characteristics | Vaginal Birth (n = 83) | Planned C/S (n = 178) | Emergency C/S (n = 77) |
---|---|---|---|
Maternal Age (years) | 28.4 ± 4.1 (16–42) | 28.3 ± 4.3 (17–51) | 27.9 ± 4.2 (16–43) |
Pregestational BMI (kg/m2) | 25.9 ± 3.1 (19.1–34.2) | 26.4 ± 3.2 (19.8–34.8) | 26.1 ± 3.3 (19.6–34.5) |
Weight Gain During Pregnancy (kg) | 14.6 ± 4.5 (7–26) | 15.0 ± 4.7 (8–27) | 14.7 ± 5.0 (7–25) |
Education Level: Primary | 39 (47.0%) | 76 (42.7%) | 34 (44.2%) |
Education Level: Secondary | 16 (19.3%) | 34 (19.1%) | 13 (16.9%) |
Education Level: High School | 16 (19.3%) | 38 (21.3%) | 12 (15.6%) |
Education Level: University | 12 (14.4%) | 30 (16.9%) | 18 (23.3%) |
Mother’s Profession: Healthcare Worker | 4 (4.8%) | 11 (6.2%) | 7 (9.1%) |
Mother’s Profession: Housewife | 65 (78.3%) | 136 (76.4%) | 61 (79.2%) |
Mother’s Profession: Civil Servant | 3 (3.6%) | 10 (5.6%) | 2 (2.6%) |
Mother’s Profession: Teacher | 5 (6.0%) | 11 (6.2%) | 4 (5.2%) |
Mother’s Profession: Factory Worker | 6 (7.2%) | 10 (5.6%) | 3 (3.9%) |
Breastfeeding Outcomes | Vaginal Birth (n = 83) | Planned C/S (n = 178) | Emergency C/S (n = 77) | p |
---|---|---|---|---|
Initiation of Breastfeeding within 1 h | 85.5% (71/83) | 57.9% (103/178) | 64.9% (50/77) | <0.001 |
Breastfeeding Continuation at 1 Month | 98.8% (82/83) | 98.3% (175/178) | 98.7% (76/77) | 0.945 |
Breastfeeding Continuation at 3 Months | 96.4% (80/83) | 96.1% (171/178) | 94.8% (73/77) | 0.853 |
Breastfeeding Continuation at 6 Months | 95.2% (79/83) | 94.4% (168/178) | 94.8% (73/77) | 0.880 |
Formula Supplementation at 1 Month | 13.3% (11/83) | 16.9% (30/178) | 16.9% (13/77) | 0.724 |
Formula Supplementation at 6 Months | 16.9% (14/83) | 18.0% (32/178) | 18.2% (14/77) | 0.967 |
Complementary Feeding at 6 Months | 24.1% (20/83) | 24.2% (43/178) | 24.7% (19/77) | 0.995 |
Subscale | Time Point | Vaginal Birth (n = 83) | Planned C/S (n = 178) | Emergency C/S (n = 77) | p |
---|---|---|---|---|---|
Positioning | Birth | 1.60 ± 0.28 (1.0–2.0) | 1.42 ± 0.30 (0.9–1.9) | 1.19 ± 0.35 (0.7–1.8) | <0.001 |
Positioning | 1 Month Postpartum | 1.95 ± 0.15 (1.6–2.0) | 1.93 ± 0.18 (1.5–2.0) | 1.84 ± 0.21 (1.4–2.0) | 0.045 |
Positioning | 3 Months Postpartum | 1.99 ± 0.05 (1.8–2.0) | 1.98 ± 0.07 (1.7–2.0) | 1.96 ± 0.10 (1.6–2.0) | 0.321 |
Positioning | 6 Months Postpartum | 2.00 ± 0.00 (2.0–2.0) | 1.99 ± 0.05 (1.9–2.0) | 1.98 ± 0.08 (1.7–2.0) | 0.658 |
Attachment | Birth | 1.52 ± 0.33 (0.9–2.0) | 1.33 ± 0.35 (0.8–1.9) | 1.08 ± 0.39 (0.6–1.7) | <0.001 |
Attachment | 1 Month Postpartum | 1.92 ± 0.17 (1.5–2.0) | 1.91 ± 0.19 (1.4–2.0) | 1.82 ± 0.24 (1.3–2.0) | 0.039 |
Attachment | 3 Months Postpartum | 1.98 ± 0.07 (1.8–2.0) | 1.97 ± 0.09 (1.6–2.0) | 1.94 ± 0.11 (1.6–2.0) | 0.284 |
Attachment | 6 Months Postpartum | 1.99 ± 0.06 (1.8–2.0) | 1.98 ± 0.08 (1.7–2.0) | 1.96 ± 0.10 (1.7–2.0) | 0.710 |
Sucking | Birth | 1.59 ± 0.29 (1.0–2.0) | 1.39 ± 0.31 (0.8–1.9) | 1.16 ± 0.38 (0.7–1.8) | <0.001 |
Sucking | 1 Month Postpartum | 1.94 ± 0.16 (1.6–2.0) | 1.92 ± 0.20 (1.5–2.0) | 1.83 ± 0.23 (1.4–2.0) | 0.042 |
Sucking | 3 Months Postpartum | 1.99 ± 0.04 (1.8–2.0) | 1.98 ± 0.06 (1.7–2.0) | 1.96 ± 0.09 (1.7–2.0) | 0.299 |
Sucking | 6 Months Postpartum | 2.00 ± 0.00 (2.0–2.0) | 1.99 ± 0.04 (1.9–2.0) | 1.98 ± 0.07 (1.8–2.0) | 0.688 |
Swallowing | Birth | 1.54 ± 0.35 (0.9–2.0) | 1.29 ± 0.36 (0.7–1.8) | 1.09 ± 0.37 (0.7–1.7) | <0.001 |
Swallowing | 1 Month Postpartum | 1.91 ± 0.18 (1.5–2.0) | 1.90 ± 0.21 (1.3–2.0) | 1.81 ± 0.25 (1.3–2.0) | 0.037 |
Swallowing | 3 Months Postpartum | 1.98 ± 0.08 (1.8–2.0) | 1.97 ± 0.10 (1.6–2.0) | 1.94 ± 0.12 (1.6–2.0) | 0.317 |
Swallowing | 6 Months Postpartum | 1.99 ± 0.06 (1.8–2.0) | 1.98 ± 0.08 (1.7–2.0) | 1.96 ± 0.09 (1.7–2.0) | 0.703 |
Delivery Method | BBAT Component | F-Value | df | p-Value | η2 | Absolute Change (Birth→6th Month) | Relative Change |
---|---|---|---|---|---|---|---|
Vaginal Birth (n = 83) | Positioning | 64.7 | −3246 | <0.001 | 0.441 | +0.41 | +25.9% |
Attachment | 47.1 | −3246 | <0.001 | 0.365 | +0.36 | +22.1% | |
Sucking | 84.8 | −3246 | <0.001 | 0.508 | +0.47 | +30.9% | |
Swallowing | 91.5 | −3246 | <0.001 | 0.527 | +0.49 | +32.9% | |
Total BBAT Score | 68.5 | −3246 | <0.001 | 0.455 | +0.43 | +27.6% | |
Planned Cesarean (n = 178) | Positioning | 249.3 | −3531 | <0.001 | 0.584 | +0.55 | +38.5% |
Attachment | 296.0 | −3531 | <0.001 | 0.626 | +0.60 | +43.5% | |
Sucking | 386.2 | −3531 | <0.001 | 0.686 | +0.68 | +51.9% | |
Swallowing | 411.6 | −3531 | <0.001 | 0.699 | +0.71 | +55.9% | |
Total BBAT Score | 330.0 | −3531 | <0.001 | 0.651 | +0.63 | +46.7% | |
Emergency Cesarean (n = 77) | Positioning | 182.0 | −3228 | <0.001 | 0.705 | +0.73 | +58.9% |
Attachment | 262.7 | −3228 | <0.001 | 0.776 | +0.87 | +79.1% | |
Sucking | 247.9 | −3228 | <0.001 | 0.765 | +0.84 | +73.7% | |
Swallowing | 297.9 | −3228 | <0.001 | 0.797 | +0.92 | +87.6% | |
Total BBAT Score | 244.1 | −3228 | <0.001 | 0.762 | +0.84 | +74.3% |
Variables | Immediate Skin-to-Skin Contact | Newborn Birth Weight | NICU Admission | BBAT Score at Birth |
---|---|---|---|---|
Pregestational BMI | −0.113 (0.056) | 0.164 (0.003) * | −0.097 (0.075) | −0.086 (0.115) |
Weight Gain During Pregnancy | −0.103 (0.059) | 0.274 (<0.001) ** | −0.058 (0.287) | −0.073 (0.180) |
Vaginal Birth Duration | −0.296 (0.007) ** | 0.287 (0.009) ** | −0.174 (0.116) | 0.182 (0.100) |
Immediate Skin-to-Skin Contact | 1 | −0.411 (<0.001) ** | −0.798 (<0.001) ** | −0.117 (0.032) * |
Newborn Birth Weight | −0.411 (<0.001) ** | 1 | 0.346 (<0.001) ** | 0.377 (<0.001) ** |
NICU Admission | −0.798 (<0.001) ** | 0.346 (<0.001) ** | 1 | 0.321 (<0.001) ** |
BBAT Score at 1 Month | −0.089 (0.103) | 0.377 (<0.001) ** | 0.321 (<0.001) ** | 0.413 (<0.001) ** |
BBAT Score at 3 Months | −0.278 (<0.001) ** | 0.281 (0.010) ** | 0.185 (0.001) ** | 0.317 (<0.001) ** |
BBAT Score at 6 Months | −0.076 (0.162) | 0.062 (0.255) | 0.038 (0.491) | 0.073 (0.181) |
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Özer Aslan, İ.; Aslan, M.T.; Can, N.; Sevinç Ergül, Ö.; Çallıoğlu, N. Impact of Delivery Method on Initiation and Continuation of Breastfeeding: A Prospective Cohort Study. Children 2025, 12, 966. https://doi.org/10.3390/children12080966
Özer Aslan İ, Aslan MT, Can N, Sevinç Ergül Ö, Çallıoğlu N. Impact of Delivery Method on Initiation and Continuation of Breastfeeding: A Prospective Cohort Study. Children. 2025; 12(8):966. https://doi.org/10.3390/children12080966
Chicago/Turabian StyleÖzer Aslan, İlke, Mustafa Törehan Aslan, Nebibe Can, Özlem Sevinç Ergül, and Nihal Çallıoğlu. 2025. "Impact of Delivery Method on Initiation and Continuation of Breastfeeding: A Prospective Cohort Study" Children 12, no. 8: 966. https://doi.org/10.3390/children12080966
APA StyleÖzer Aslan, İ., Aslan, M. T., Can, N., Sevinç Ergül, Ö., & Çallıoğlu, N. (2025). Impact of Delivery Method on Initiation and Continuation of Breastfeeding: A Prospective Cohort Study. Children, 12(8), 966. https://doi.org/10.3390/children12080966