Cesarean section and breastfeeding outcomes in an Indigenous Qom community with high breastfeeding support

MARTIN, MELANIE; KEITH, MONICA; OLMEDO, SOFÍA; EDWARDS, DEJA; BARRIENTES, ALICIA; PAN, ANWESHA; VALEGGIA, CLAUDIA

Evolution, Medicine, and Public Health

Oxford University Press

Lugar: Oxford; Año: 2022 vol. 10 p. 36 - 46

Background and objectives: Cesarean section may lead to suboptimal breastfeeding outcomes, thoughevidence has been mixed. Factors, such as premature birth, birth weight and maternal age may inde-pendently increase risk of cesarean and hinder breastfeeding initiation, while maternal preferences,support and sociostructural barriers may influence breastfeeding practices beyond the immediate post-partum period.Methodology: We assessed impacts of cesarean section and gestational factors on breastfeeding dur-ation among Indigenous Qom mothers in Argentina who have strong traditional breastfeeding sup-port. We modeled transitions from exclusive breastfeeding to complementary feeding and from com-plementary feeding to full weaning in a Bayesian time-to-event framework with birth mode andgestational covariates (n ¼89 infants).Results: Estimated median time to full weaning was 30 months. Cesarean-delivered babies wereweaned an average of 5 months later adjusting for gestational age, maternal parity and infant sex. Nofactors were associated with time-to-complementary feeding, and time-to-complementary feeding wasnot associated with time-to-full weaning.Conclusions and implications: Among Indigenous Qom mothers in Argentina, cesarean section wasnot associated with suboptimal breastfeeding outcomes. Although some Qom mothers do experience early breastfeeding problems, particularly following first birth, problems are not more frequent following cesarean delivery. Traditionalpostpartum kin and community support during prolonged postpartum periods may be instrumental in helping mothers to overcomeearly breastfeeding problems due to cesarean or other risk factors.Lay Summary: We examined associations between cesarean section and breastfeeding transitions among Indigenous mothers inArgentina. Mothers delivering via cesarean section did not introduce complementary foods earlier, and conversely weaned later thanmothers who delivered vaginally. Postpartum kin support typical of traditional birthing practices may help mothers overcome earlybreastfeeding problems