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      Association of postoperative nausea/vomiting and pain with breastfeeding success

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          Abstract

          Background

          Successful breastfeeding is a goal set forth by the World Health Organization to improve neonatal care. Increasingly, patients express the desire to breastfeed, and clinicians should facilitate successful breastfeeding. The primary aim of this study is to determine if postoperative nausea and vomiting (PONV) or postoperative pain are associated with decreased breastfeeding success after cesarean delivery.

          Methods

          This is a historical cohort study using the Stony Brook Elective Cesarean Delivery Database. Self-reported breastfeeding success at 4 weeks postoperative was analyzed for associations with postoperative antiemetic use and postoperative pain scores. Breastfeeding success was also analyzed for associations with patient factors and anesthetic medications.

          Results

          Overall, 86% of patients ( n = 81) who intended on breastfeeding reported breastfeeding success. Breastfeeding success was not associated with postoperative nausea or vomiting as measured by post anesthesia care unit antiemetic use (15% use in successful vs. 18% use in unsuccessful, p = 0.67) or 48-h antiemetic use (28% use in successful group vs 36% use in unsuccessful group, p = 0.732). Pain visual analog scale scores at 6, 12 and 24 h postoperatively were not significantly different between patients with or without breastfeeding success. Breastfeeding success was associated with having had at least 1 previous child (86% vs 36%, p < 0.001). Patients with asthma were less likely to have breastfeeding success (45% vs 4%, p = 0.002).

          Conclusions

          Efforts to improve PONV and pain after cesarean delivery may not be effective in improving breastfeeding success. To possibly improve breastfeeding rates, resources should be directed toward patients with no previous children and patients with asthma.

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          Most cited references14

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          Simplified postoperative nausea and vomiting impact scale for audit and post-discharge review.

          Postoperative nausea and vomiting (PONV) is common but many episodes may be trivial or transient. The aim of the study was to develop a simple-to-use measure of the intensity and clinical impact of PONV.
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            Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum.

            Although breastfeeding is known to be beneficial to both mother and infant, many women encounter barriers to breastfeeding, even after successful breastfeeding initiation, which may put them at greater risk for early cessation of breastfeeding. The objectives of this study were to conduct a secondary analysis of data from a longitudinal study of postpartum depression to (a) examine factors related to very early discontinuation of breastfeeding (at 2 weeks postpartum) following hospital discharge and (b) identify women's reasons for very early cessation of breastfeeding. The results of this study support findings from previous research. Having a perceived support system, whether it is personal or professional, may have an effect on both the initiation and duration of breastfeeding. Educating expectant and new mothers, especially women who encounter multiple barriers and are at risk for very early cessation of breastfeeding, of the benefits of breastfeeding and supporting them in developing efficient techniques and problem-solving skills can help increase the duration of breastfeeding.
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              Low breastfeeding rates and public health in the United States.

              The medical community has orchestrated breastfeeding campaigns in response to low breastfeeding rates twice in US history. The first campaigns occurred in the early 20th century after reformers linked diarrhea, which caused the majority of infant deaths, to the use of cows' milk as an infant food. Today, given studies showing that numerous diseases and conditions can be prevented or limited in severity by prolonged breastfeeding, a practice shunned by most American mothers, the medical community is again inaugurating efforts to endorse breastfeeding as a preventive health measure. This article describes infant feeding practices and resulting public health campaigns in the early 20th and 21st centuries and finds lessons in the original campaigns for the promoters of breastfeeding today.
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                Author and article information

                Contributors
                Ramon.abola@stonybrookmedicine.edu
                jamie.Romeiser@stonybroomkmedicine.edu
                suman.grewal@stonybrookmedicine.edu
                Sabeen.rizwan@stonybrookmedicine.edu
                rishimani.adsumelli@stonybrookmedicine.edu
                ellen.steinberg@stonybrookmedicine.edu
                Elliott.Bennett-Guerrero@stonybrookmedicine.edu
                Journal
                Perioper Med (Lond)
                Perioper Med (Lond)
                Perioperative Medicine
                BioMed Central (London )
                2047-0525
                22 November 2017
                22 November 2017
                2017
                : 6
                : 18
                Affiliations
                GRID grid.459987.e, Stony Brook Medicine, Department of Anesthesiology, ; HSC-4-060, Stony Brook, NY 11794 USA
                Author information
                http://orcid.org/0000-0003-1223-2952
                Article
                75
                10.1186/s13741-017-0075-2
                5700740
                29201358
                cab229d8-0a99-4071-99b6-9f8ebf747256
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 January 2017
                : 27 October 2017
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                breastfeeding,postoperative pain,postoperative nausea and vomiting (ponv),prelabor cesarean delivery

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