Determinants of postpartum lactation insufficiency in caesarean section in Chinese mothers: A cross-sectional study

This study explored the status of postpartum lactation in caesarean section mothers and identified the factors that influence lactation insufficiency. A total of 265 mothers who delivered via cesarean section between November 2021 and November 2022 were followed for six months. Lactation efficiency was measured by collecting daily milk output using a breast pump from postpartum days 1 to 10; insufficient lactation was defined as a total daily milk volume <500 mL on day 10. Lactation typically began between 25 and 48 hours postpartum (45.1%), with a delayed onset of lactogenesis incidence of 19.6% and an overall lactation insufficiency rate of 48.3%. Multivariate logistic regression analysis identified advanced maternal age (>35 years), excessive weight gain during pregnancy (≥5.6 kg/m²), high postpartum pain scores (≥4), gestational diabetes mellitus, and postpartum depression as significant risk factors for insufficient lactation. In contrast, early skin-to-skin contact and suckling significantly reduced the risk. Furthermore, infants in the exclusive breastfeeding group showed significantly better nutritional outcomes, as measured by the Kaup index, compared to partially or non-breastfed infants. These findings underscore the need for targeted clinical interventions during the perinatal period, including effective pain management, mental health support, and promotion of early breastfeeding, to enhance lactation outcomes among cesarean section mothers.