ABSTRACT

Background: Early initiation of breastfeeding defined as putting the neonate to the breast within the first hour of life, is a critical intervention for ensuring long-term breastfeeding success. However, early breastfeeding initiation rates are low in common practice, especially following Caesarean delivery. It is important that post-operative management protocols with duration of hospital stay are examined as they impact on the initiation of breastfeeding after uncomplicated Caesarean delivery. The study aims to determine and compare the time of initiation of breastfeeding in the ultra-short versus the traditional post-operative management protocol after uncomplicated Caesarean delivery.
Methods: A randomized controlled trial done in three centres in Bayelsa state, South-South Nigeria. The Federal Medical Centre, Yenagoa, the Niger Delta University Teaching Hospital, Okolobiri, and the Diete-Koki Memorial Hospital, Opolo. A total of 179 women who just had uncomplicated Caesarean delivery were randomized into the ultra-short stay (90) and traditional groups (89), and were recruited in the recovery room immediately after the uncomplicated Caesarean delivery. The women in the ultra-short stay group were given minty chewing gums (menthos) to chew for two hours, within the first six hours after surgery; started ambulating and commenced oral intake with catheter discontinued 6-12 hours post-operative. The traditional group was ambulant, oral intake initiated and urethral catheter discontinued 12-24 hours post-operative. The neonates were put to the mother’s breast by the healthcare provider (the Nurse on duty or occasionally the attending Doctor) as soon as she was disposed to breastfeed. In the ultra-short stay group, the wounds were inspected, exposed and the patient discharged at 36-48 hours post-operative. In the traditional group, the wounds were inspected and exposed and patient discharged on day 3-5.
Results:. The mean time of initiation of breastfeeding was 1.3 and 2.4 days in the ultra-short and traditional hospital-stay groups respectively. The ultra-short stay group had significantly earlier initiation of breastfeeding (t=2.92, p<0.001, CI=1.35-1.84, RR=1.58).
Conclusion: There is earlier initiation of breastfeeding in the ultra-short stay than the traditional hospital-stay protocol, after uncomplicated Caesarean delivery.
Trial was retrospectively registered by the Pan African Clinical Trials Registry(PACTR), number PACTR202509662932971, 11 September, 2025.

KEYWORDS

early, initiation; breastfeeding; uncomplicated Caesarean delivery; ultra-short stay; traditional protocol; Bayelsa.

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