Impact of Caesarean Delivery on Early Initiation of Breastfeeding in Health Facilities in India: A Secondary Data Analysis Using NFHS-5 Data

Introduction: Early initiation of breastfeeding (EIBF) is crucial for neonatal survival and wellbeing. Caesarean section (C-section) is known to delay EIBF due to reduced opportunity for mother-infant contact. Objective: To assess the association between C-section and Early initiation of breastfeeding (EIBF) in institutional deliveries in India. Method: Secondary data analysis of NFHS-5 data (2019–21) was conducted. Statistical analysis was performed using R programming version 4.5.2. The exposure variable studied was type of delivery (Caesarean or Vaginal), main outcome was Early Initiation of Breastfeeding. Results: Early Initiation of Breastfeeding (EIBF) was observed in 47% of 127,969 institutional births and was found to be lower following C-section (aOR 0.51, 95% CI: 0.48–0.54). Maternal education, birthweight, ANC visits, and urban residence positively correlated with EIBF. Conclusion: C-section was significantly associated with delay in Early Initiation of Breastfeeding. Active support and targeted intervention for mother-baby dyad could potentially increase EIBF rates.