Application of Survival Analysis for the Assessment of Association between the Initiation time of Breastfeeding and Related Maternal and Neonatal Factors

Breastfeeding has many psychological, immunological, economical and health related benefits for mothers and their neonates. This feeding, especially at the first hours of birth is very notable, so that early breastfeeding can prevent neonatal infectious diseases and some chronic diseases in adulthood period. Moreover, breast feeding and physical contact between mother and neonate over a short period of time after delivery can influence the mother's psychological status and emotional feeling with her neonate. The aim of the present study was to assess factors that influence the time between delivery and the first breastfeeding. The statistical methods used for comparison of data were Cox regression, Log-rank test and Kaplan-Meier curve. In this cohort study, 110 paired mothers and their neonates were recruited in a hospital in Tehran. The data collected included time of first feeding following delivery in relation to the method of delivery, parity and the level of education of mother. The results showed that mode of delivery was the most important factor for starting the first breastfeeding, so that for any time duration after birth, the rate of breastfeeding for neonates in normal vaginal delivery method was 3.9 and 6.8 folds in usual and spinal cesarean delivery methods respectively. Other important factors, in sequence, were parity and educational level in mothers. The finding of this study demonstrated that increasing the awareness among pregnant women and their willingness for vaginal delivery can decrease in unnecessary cesarean section rate and can improve the relation between mother and neonate and the start of early breastfeeding.