Factors impairing exclusive breastfeeding initiation in women who received labor neuraxial analgesia: A single-center retrospective observational study in Japan

Background: Breastfeeding is beneficial for both the mother and infant. However, the factors impairing initiation of exclusive breastfeeding have not been sufficiently investigated in women that received labor neuraxial analgesia. This study aims to clarify the rate of successful initiation of exclusive breastfeeding in women that received labor neuraxial analgesia in our hospital, and any factors impairing it at one month postpartum. Methods: We retrospectively reviewed the 376 women who had received labor neuraxial analgesia between January 2011 and May 2022. Univariate and multivariate logistic regression analyses were performed to determine factors influencing exclusive breastfeeding. Results: The rate of exclusive breastfeeding at one month in women who received labor neuraxial analgesia was 43.1%. Exclusive breastfeeding was shown to have univariate association with multiparity ( P = 0.0001), second stage of labor ( P = 0.046), oxytocin use ( P < 0.0001), vacuum extraction delivery ( P = 0.001), amount of bleeding ( P = 0.027), and neonatal birthweight ( P = 0.010). Multivariate logistic regression analysis revealed that oxytocin use and vacuum extraction delivery were mother-related factors and lower birthweight was an infant-related factor that were significant predictors of impairment of the initiation of exclusive breastfeeding at one month after delivery. Conclusion: Oxytocin use and vacuum extraction delivery as maternal factors and lower birthweight as an infant factor were shown to be a significant predictors of impairment of the initiation of exclusive breastfeeding at one month after delivery.