Factors influencing successful breastfeeding practices among post-cesarean section mothers in a selected hospital in Indonesia

Mothers who have undergone a caesarea section deliveries encounter issues with the breastfeeding process. Latching difficulty, and shorter breastfeeding intervals influence successful breastfeeding practices among post-cesarean section mothers.

Caesarean section is associated with postoperative pain ranging from moderate to severe [1]. As a result, the mothers may experience difficulty breastfeeding, leading to a low breastfeeding success rate [2]. Caesarean section makes mothers vulnerable to changes in their physical activity patterns, reducing their ability to breastfeed and care for their infants [3]. Consequently, there is a possibility of not achieving success in breastfeeding [4]. Mothers' breastfeeding experience at home is somewhat known. Understanding the mothers’ breastfeeding experiences is necessary to identify factors influencing breastfeeding practices among post-caesarean section mothers. We have examined the factors related to successful breastfeeding in a selected Indonesian hospital. This would assist in developing interventions to eliminate any obstacle identified [4], [5].

This descriptive study interviewed 100 post-caesarean-section mothers with healthy infants in the Ayyub ward at Roemani Hospital Semarang from May to August 2023. The interview schedule of this study consisted of two components. The first component included the mother’s age, education level, occupation, parity, and birth weight and appearance, pulse, grimace, activity and respiration (APGAR) scores of infants. The second component included the four variables related to the breastfeeding assessment score (BAS): previous breastfeeding experience, latching difficulty, breastfeeding interval, and formula milk quantity. Each of these variables was scored 2 for a favourable response. Therefore, a total score of 8 was considered a successful breastfeeding. Mothers' age, infant’s birth weight and APGAR score were presented as mean (standard deviation), and compared using a t-test between successful and failed groups; all other variables were presented as numbers (per cent) and compared using a chi-square test.

The mean age of mothers was similar (30.1 vs 29.9) between groups. Infants’ birth weight (3,369 vs 3,371) and APGAR scores (minute 1: 9.4 vs 9.2, minute 5: 9.7 vs 9.9, minute 10: 10.1 vs 9.8) were similar. Difficulty in latching onto the nipple and a shorter breastfeeding interval were significantly associated with successful breastfeeding (Table 1).

The role of knowledge in latching has a big impact on the success of breastfeeding. When someone has good knowledge and experience in providing breastfeeding, the baby's nutritional needs will be sufficient so that the baby will be healthier and grow better [6]. Breastfeeding at <3 hours frequency is known to be associated with better milk production [7]. This condition increases the mother's satisfaction in giving breast milk. Most mothers feel sad if the milk amount is insufficient, so they consider starting formula milk [8]. When babies consume formula milk, they will be more likely to consume formula milk because it is easier to suck. As a result, babies no longer want to consume breast milk anymore. Mothers should be counselled to breastfeed more frequently and demonstrate how to overcome the latching onto the nipple.

Table 1 Comparison of variables between successful and unsuccessful breastfeeding attempts

We would like to thank all participants.

Conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: NK, M, E, PLR, SP. Drafting the work or reviewing it critically for important intellectual content: NK, M, E, PLR, SP. Final approval of the version to be published: NK, M, E, PLR, SP. Accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: NK.

We do not have any conflict of interest.

We confirm that the data supporting the findings of the study will be shared upon reasonable request. 

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