Factors Influencing Exclusive Breastfeeding at Discharge Among First-Time Mothers Undergoing Cesarean Section

  • อริสรา สวัสดิ์พาณิชย์ Registered Nurse, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
  • สุสัณหา ยิ้มแย้ม Correspondent author, Professor, Faculty of Nursing, Chiang Mai University, Thailand
  • นงลักษณ์ เฉลิมสุข Instructor, Faculty of Nursing, Chiang Mai University
Keywords: exclusive breastfeeding, perceived benefits of breastfeeding, perceived barriers to breastfeeding, breastfeeding self-efficacy, maternity care practices, mothers undergoing cesarean section


Breastfeeding is considerably beneficial to infants, mothers, and society. Nevertheless, mothers who have undergone cesarean section are a risk group for lower rates of exclusive breastfeeding as well as shortened breastfeeding duration. The purpose of this descriptive correlational research was to describe breastfeeding among first-time mothers who have undergone cesarean section, and to examine the relationships between exclusive breastfeeding and selected factors including perceived benefits of breastfeeding, perceived barriers to breastfeeding, breastfeeding self-efficacy, and maternity care practices. The participants were 144 first-time mothers who underwent cesarean section at two tertiary hospitals in Bangkok, Thailand. Purposive sampling was used to recruit the participants on the basis of inclusion criteria. Data were collected from July 2017 to January 2018 by using questionnaires consisting of the Demographic Data Recording Form; the Perceived Breastfeeding Benefits Questionnaire; the Perceived Breastfeeding Barriers Questionnaire; Dennis’s Breastfeeding Self-Efficacy Short-Form Scale (BSES-SF); the Questionnaire of Maternity Care Practice, and the Breastfeeding Practices Questionnaire. The measures of reliability among the instruments were .87, .95, .93, .80 and 1, respectively. Data were collected by the researcher and analyzed using descriptive statistics and Point-Biserial correlation.

          Results of the study revealed that exclusive breastfeeding rates were 33.3% at hospital discharge and 39.1% at the first month postpartum among first-time mothers who had undergone cesarean section. The primary reason for feeding formula to the infants was insufficient milk supply. Furthermore, there was a significantly positive relationship between maternity care practices and exclusive breastfeeding at hospital discharge (rpb=.359, p<.01). The findings suggest that nurse-midwives and other health care professionals should protect, promote, and support exclusive breastfeeding, especially among new mothers who undergo cesarean sections. Intervention and strategies should be implemented focusing on maternity care practices aligned with the Ten Steps to Successful Breastfeeding of the BFHI and on the basis of the health care sphere across the perinatal continuum in order to encourage those mothers to successfully exclusive breastfeed.


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Research Article