Timely initiation of breastfeeding and its factors among women delivered via cesarean section under spinal anesthesia at the University of Gondar Comprehensive Specialized Hospital, north-west Ethiopia, 2021: a hospital-based cross-sectional study

The mode of delivery influences breastfeeding practice. Moreover, cesarean deliveries under anesthesia-related risk factors affect the timing of breastfeeding initiation compared to vaginal deliveries. In addition, high rates of cesarean section (CS) deliveries and low breastfeeding rates are important public health concerns for all developing countries. OBJECTIVE: This study aimed to determine the timely initiation of breastfeeding and its factors among women delivered via CS under spinal anesthesia. METHODS: Institutional-based cross-sectional study was employed among 422 systematically selected mothers from April to June 2021. Data were collected by a structured questionnaire. Data entry and analysis were done using Epi Data and Stata version 14.0. Binary logistic regressions were computed to identify factors. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare statistical significance. RESULTS: Delayed initiation of breastfeeding (DIBF) was 41.8%. Mothers who had an emergency CS (AOR =2.13, 95% CI [1.21–3.75]), had less than four antenatal care (ANC) follow-ups (AOR=1.77, 95% CI [1.02–3.13]), had moderate to severe pain during the perioperative period (AOR=2.65, 95% CI [1.24–5.54]), primipara (AOR=1.89; 95% CI [1.20–3.25]), used intraoperative opioid medications (AOR=1.86; 95% CI [1.01–3.30]), and had no skin-to-skin contact (AOR=2.1, 95% CI [1.27–3.51]) were associated with DIBF. CONCLUSION AND RECOMMENDATION: DIBF after cesarean delivery was high. Emergency CS, less than four ANC visits, immediate postoperative pain, and lack of skin-to-skin contact were factors associated with delayed breastfeeding. Health care providers, especially anesthetists, in the operation theater, should implement multimodal analgesics and minimize opioid consumption. Moreover, they should keep the newborn in skin-to-skin contact to initiate breastfeeding in the operation theater soon after birth.