Association between mode of delivery and breastfeeding practices in Egypt: secondary analysis of Egypt Demographic and Health Survey

Abstract

Background: The rise in caesarean deliveries constitutes a major public health concern in low- and middle-income countries (‎LMICs)‎. Evidence on the influence of caesarean delivery on breastfeeding practices in LMICs is currently lacking. Aims: To examine the association between mode of delivery and breastfeeding initiation and prelacteal feeding practices in a nationally representative sample of Egyptian women. Methods: A cross-sectional study was carried out on 3773 women from the 2014 Egypt Demographic and Health Survey. The outcomes of interest were the timing of breastfeeding initiation and prelacteal feeding practices. Descriptive statis- tics and multivariable logistic regression models were performed. Results: Overall, 25.1% of mothers-initiated breastfeeding within 1 hour of birth and 63.5% practised prelacteal feeding within 3 days of birth. Mothers who had caesarean delivery had higher odds of delayed breastfeeding initiation [‎adjusted odds ratio (‎AOR)‎ 2.25; 95% confidence interval (‎CI)‎: 1.84–2.74]‎ and were more likely to engage in prelacteal feeding (‎AOR: 1.44; 95% CI, 1.19–1.74)‎. Moreover, the relationship between caesarean delivery and delayed breastfeeding initiation varied by parity with stronger association among multiparous (‎AOR: 2.57; 95% CI, 2.04–3.24)‎ compared with primiparous mothers (‎AOR: 1.52; 95% CI, 1.03–2.25)‎. Conclusion: Caesarean delivery significantly increased the likelihood of delayed breastfeeding initiation and increased prelacteal feeding practices. Breastfeeding support and guidance should target women considering caesarean delivery.