Hello!  I am Rachel Borsheim a nursing student at the University of North 
Dakota.  I am currently taking a child bearing class and participating in 
clinicals in the Labor and Delivery unit at the hospital.  This is an 
interesting area of nursing for me and I have really enjoyed the 
experiences that I have had so far.  I have been subscribed to the listserv 
for a few weeks now and have enjoyed reading the posts about breastfeeding 
as I am a strong supporter of breast feeding myself.  
One area of concern for me is the initiation and duration of breast feeding 
for mothers and babies following a cesarean section.  During my first week 
at clinicals I cared for a baby who was delivered via cesarean section.  
Following delivery, the baby was brought back to the unit and the mother 
did not return to him for about two hours.  She was a breast feeding mom 
and had to wait at least two hours before initiating breast feeding.  
During my research on this topic I found that early initiation is important 
with breastfeeding.  According to Rowe-Murray and Fisher (2002), Step 4 of 
the Ten Steps to Successful Breastfeeding says that mothers need guidance 
to initiate infant breastfeeding within 30 minutes to 1 hour of birth.  My 
mother was unable to meet these requirements.  
Another study I found that dealt with breastfeeding initiation had similar 
information.  Kamenwa and Mirie (1997), explain that the most critical 
period for initiation of breastfeeding is the immediate period following 
delivery.  This was difficult for my mother to accomplish because she was 
recovering from surgery in the PACU while the baby was being cared for in 
the nursery.    
Lastly, I found a study on the effect of operative delivery on 
breastfeeding success.  According to Patel, Liebling, and Murphy (2003), 
the best breastfeeding outcomes for women who delivered via cesarean 
section were in the women who had longer hospital stays as compared to the 
women who left the hospital earlier.  
My questions for you are have you seen any problems with the late 
initiation of breastfeeding in cesarean section mothers and do you think 
that longer hospital stays are necessary for the successful breastfeeding 
outcomes?  Also, are there any extra considerations for the women who 
deliver via cesarean and wait longer to initiate breastfeeding?  
Thank you, 
Rachel Borsheim SN

Kamenwa, R. and Mirie, W. (1997). Breastfeeding hospital practices as 

reported by Mothers at Kenyatta National Hospital in Nairobi, Kenya. 

International Journal of Childbirth Education,  12(4),  22-25.  

Patel, R., Liebling, R., and Murphy, D. (2003). Effect of operative 

delivery in the second stage of labor on breastfeeding success. Birth, 30

(4), 255-260.  

Rowe-Murray, H. and Fisher, J. (2002). Baby friendly hospital practices: 

cesarean section is a persistent barrier to early initiation of 

breastfeeding. Birth, 29(2), 124-131. 

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