Comparison of the breastfeeding patterns of mothers who delivered their babies per vagina and via cesarean section: An observational study using the LATCH breastfeeding charting system

ArticleinInternational Journal of Nursing Studies 44(7):1128-37 · September 2007with122 Reads
DOI: 10.1016/j.ijnurstu.2006.04.018 · Source: PubMed
Abstract
Breastfeeding has many advantages for both mothers and infants. Several factors related to the mother and the baby, however, have a negative effect on the initiation of breastfeeding. Mode of delivery is one of these factors. When delivery takes place by cesarean section, the mother becomes a surgical patient with all the inherent risks and problems. Cesarean delivery under general anesthesia rates are currently rising our country, but the effects of this factor on the initiation and duration of breastfeeding are unclear. The purpose of this study was to assess and compare the breastfeeding process in mothers who had cesarean deliveries (CD) with those who delivered vaginally (VD). This study is an observational and comparative study. The environment of the research was the private hospital in Istanbul. The samples in the research were volunteer participant mothers who were delivered of healthy neonates. There were 118 incidents of CD under general anesthesia and 82 of VD chosen for the study. Data was obtained using an "Introductory Information Form" which was prepared as suggested by related literature, and by using the "(LATCH) Breastfeeding Charting System." According to the LATCH Scoring System, the average score for the first breastfeeding was 6.27 and 8.81 for the third in CD mothers and 7.46 for the first breastfeeding and 9.70 for the third in VD mothers. Statistically meaningful differences were defined between the first (t=10.48; p<.001), second (t=7.82; p<.001), and third (t=7.12; p<.001) breastfeeding sessions in both CD and VD mothers. It was found that the pattern of delivery affects breastfeeding and that CD mothers need more support and help as compared to VD mothers. CD mothers were seen to need more support, particularly in positioning their babies for breastfeeding.
    • "A receiver operating characteristic analysis was used to evaluate sensitivity (true positive rate) and specificity (true negative rate) of the LATCH score thresholds for predicting non-exclusive breastfeeding [43]. Because mode of delivery [27] is a significant factor of the breastfeeding pattern , separate data analyses were used among vaginally (n = 669) and caesarean (n = 238) delivered women. Sensitivity referred to the capacity of the LATCH assessment tool to correctly identify postnatal women who would be at risk of non-exclusive breastfeeding, whereas specificity referred to the capacity of the LATCH assessment tool to correctly identify postnatal women who would not be at risk of non-exclusive breastfeeding [43]. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives The aim of this study was to evaluate the internal consistency, structural validity, sensitivity and specificity of the 5- and 4-item versions of the LATCH assessment tool among a multiethnic population in Singapore. Methods The study was a secondary analysis of a subset of data (n = 907) from our previous breastfeeding survey from 2013 to 2014. The internal consistency of the LATCH was examined using Cronbach’s alpha. The structural validity was assessed using an exploratory factor analysis (EFA), and the proposed factors were confirmed by confirmatory factor analysis (CFA) using separate samples. Receiver operating characteristic analysis was used to evaluate the sensitivity and specificity of the LATCH score thresholds for predicting non-exclusive breastfeeding. Results The Cronbach’s alpha values of the 5- and 4-item LATCH assessments were 0.70 and 0.74, respectively. The EFA demonstrated a one-factor structure for the 5- and 4-item LATCH assessments among a randomized split of 334 vaginally delivered women. Two CFA of the 4-item LATCH demonstrated better fit indices of the models compared to the two CFA of the 5-item LATCH among another randomized split of 335 vaginally delivered women and 238 cesarean delivered women. Using cutoffs of 5.5 and 3.5 were recommended when predicting non-exclusive breastfeeding for 5- and 4-item versions of the LATCH assessment among vaginally delivered women (n = 669), with satisfactory sensitivities (94% and 95%), low specificities (0% and 2%), low positive predictive values (25%) and negative predictive values (20% and 47%). A cutoff of 5.5 was recommended to predict non-exclusive breastfeeding for 5- and 4-item versions among cesarean delivered women (n = 238) with satisfactory sensitivities (93% and 98%), low specificities (4% and 9%), low positive predictive values (41%) and negative predictive values (65% and 75%). Therefore, the tool has good sensitivity but poor specificity, positive and negative predictive values. Conclusions We found that the 4-item version demonstrated sound psychometric properties compared to the 5-item version. Health professionals can use the 4-item LATCH as a clinical tool because it is a concise, easy-to-use and valid tool for assessing breastfeeding techniques among a multiethnic population.
    Full-text · Article · May 2016
    • "This study has shown that breastfeeding techniques were not related to exclusive breastfeeding in cesarean section group, the pattern of results appears to be consistent with previous stud- ies [7,14,18]. Women who gave by caesarean session experienced a longer separation time between time and putting their baby to breast than women given birth vaginally [7] , neurobehavioral depression caused by labor analgesia may result in delay in exclusive breastfeeding initiation [14] . In addition, post-operative pain and limited mobility might interrupted breastfeeding initiation [18]. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: The aim of this study was to examine the relationships among maternal and infant characteristics, breastfeeding techniques, and exclusive breastfeeding initiation in different modes of birth using structural equation modeling approaches. Methods: We examined a hypothetical model based on integrating concepts of a breastfeeding decision-making model, a breastfeeding initiation model, and a social cognitive theory among 952 mother-infant dyads. The LATCH breastfeeding assessment tool was used to evaluate breastfeeding techniques and two infant feeding categories were used (exclusive and non-exclusive breastfeeding). Results: Structural equation models (SEM) showed that multiparity was significantly positively associated with breastfeeding techniques and the jaundice of an infant was significantly negatively related to exclusive breastfeeding initiation. A multigroup analysis in the SEM showed no difference between the caesarean section and vaginal delivery groups estimates of breastfeeding techniques on exclusive breastfeeding initiation. Breastfeeding techniques were significantly positively associated with exclusive breastfeeding initiation in the entire sample and in the vaginal deliveries group. However, breastfeeding techniques were not significantly associated with exclusive breastfeeding initiation in the cesarean section group. Maternal age, maternal race, gestations, birth weight of infant, and postnatal complications had no significant impacts on breastfeeding techniques or exclusive breastfeeding initiation in our study. Overall, the models fitted the data satisfactorily (GFI = 0.979-0.987; AGFI = 0.951-0.962; IFI = 0.958-0.962; CFI = 0.955-0.960, and RMSEA = 0.029-0.034). Conclusions: Multiparity and jaundice of an infant were found to affect breastfeeding technique and exclusive breastfeeding initiation respectively. Breastfeeding technique was related to exclusive breastfeeding initiation according to the mode of birth. This relationship implies the importance of early effective interventions among first-time mothers with jaundice infants in improving breastfeeding techniques and promoting exclusive breastfeeding initiation.
    Full-text · Article · Nov 2015
    • "Our study also confirmed several factors generally associated with lack of EIBF such as nulliparity, delivery by caesarean section, the neonate not being put on the mother's chest after delivery, multiple births, male gender (Africa and Latin America), low birth weight, and if the neonate was resuscitated. Our study supported previous research that delivery by caesarean section is a consistent barrier to EIBF, even in the absence of any neonatal condition that interferes with early initiation of breastfeeding [16,18,27,28]. This is significant, as it delineates a major interventional target by which to improve EIBF in resource-limited settings [29] , especially given the recent increase in institutional deliveries and caesarean section rates, particularly in India. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Early initiation of breastfeeding after birth and exclusive breastfeeding through six months of age confers many health benefits for infants; both are crucial high impact, low-cost interventions. However, determining accurate global rates of these crucial activities has been challenging. We use population-based data to describe: (1) rates of early initiation of breastfeeding (defined as within 1 hour of birth) and of exclusive breastfeeding at 42 days post-partum; and (2) factors associated with failure to initiate early breastfeeding and exclusive breastfeeding at 42 days post-partum. Methods: Prospectively collected data from women and their live-born infants enrolled in the Global Network’s Maternal and Newborn Health Registry between January 1, 2010-December 31, 2013 included women-infant dyads in 106 geographic areas (clusters) at 7 research sites in 6 countries (Kenya, Zambia, India [2 sites], Pakistan, Argentina and Guatemala). Rates and risk factors for failure to initiate early breastfeeding were investigated for the entire cohort and rates and risk factors for failure to maintain exclusive breastfeeding was assessed in a sub-sample studied at 42 days post-partum. Result: A total of 255,495 live-born women-infant dyads were included in the study. Rates and determinants for the exclusive breastfeeding sub-study at 42 days post-partum were assessed from among a sub-sample of 105,563 subjects. Although there was heterogeneity by site, and early initiation of breastfeeding after delivery was high, the Pakistan site had the lowest rates of early initiation of breastfeeding. The Pakistan site also had the highest rate oflack of exclusive breastfeeding at 42 days post-partum. Across all regions, factors associated with failure to initiate early breastfeeding included nulliparity, caesarean section, low birth weight, resuscitation with bag and mask, and failure to place baby on the mother’s chest after delivery. Factors associated with failure to achieve exclusive breastfeeding at 42 days varied across the sites. The only factor significant in all sites was multiple gestation. Conclusions: In this large, prospective, population-based, observational study, rates of both early initiation of breastfeeding and exclusive breastfeeding at 42 days post-partum were high, except in Pakistan. Factors associated with these key breastfeeding indicators should assist with more effective strategies to scale-up these crucial public health interventions.
    Full-text · Article · Jun 2015
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