In a message dated 11/28/2004 11:41:36 AM Pacific Standard Time,
[log in to unmask] writes:
Subject: cesarean and breastfeeding

Here is a link to confounding variables in which cesarean can interfer with
breastfeeding. I'd be interested in research supporting the benefits of
cesarean or that breastfeeding outcomes are comparible no matter what the
route of delivery is.
http://www.plus-size-pregnancy.org/CSANDVBAC/bfaftercesarean.htm
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After reviewing the information a this site regarding C-S and breastfeeding I
am concerned about many unsubstantiated statements and "half-truths".   I am
sure the author means well, but I would not recommend the site.

The major problem with all of the research to date re breastfeeding and route
of delivery is the lack of controlling for many different issues known to be
related to initiation and duration of breastfeeding.  The most glaring is time
to first feeding (maternal access to infant).  There is no medical reason why
a stable infant born by C-S should not remain with his/her mother.  It is a
staffing and old policy issue.  Where infants are not separated (as in my
hospital), the initiation rates are the same.

Another issue is unecessary supplementation and medications and C-S.  These
issues also, have more to do with misinformed current practice than anything
inherent in a C-S.  Women can be fluid overloaded with vaginal delivery as well
- not particular to C-S.  An abstract at ILCA this year suggested that the
commonly held belief that infants whose mothers got more IV fluids had inflated
weights and lost more weight, was not true.

Low income women are more often anemic and less likely to breastfeed.  There
is considerable pain, stress and fatigue with labor as well as C-S.
Medications are used for both.  As someone who has undergone both labor and a C-S, I
felt the pain of the C-S was less. I am not advocating C-S, but we should not
assume that everyone who chooses an elective C-S is "brainwashed" or
unintelligent.

Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, Sharp Mary Birch Hospital for Women and Children's Hospital
Medical Director, Sharp HealthCare Lactation Services
San Diego, CA
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