Abstract
Mothers encounter several challenges to sustain breastfeeding until the recommended 6 months of age. There is limited evidence on the impact of women's labor pain experiences upon cessation of breastfeeding. We aimed to investigate the association between women's labor pain experiences, intrapartum interventions, and pre-birth psychological vulnerabilities and cessation of breastfeeding. This was a secondary analysis of a clinical trial conducted in a tertiary hospital in Singapore between June 2017 and July 2021. Data were obtained from participants, electronic records and surveys administered before delivery, and postpartum 6-10 weeks. A total of 624 (76.8%) women were still breastfeeding at postpartum 6-10 weeks as compared to 189 (23.2%) that had discontinued breastfeeding. Multivariable regression analysis identified lower education level (aOR 3.88, 95% CI 2.57-5.85, p < 0.0001), having diabetes (aOR, 95% CI 1.21-5.44, p = 0.0141), presence of obstetric complications (aOR 1.57, 95% CI 1.00-2.46, p = 0.0494), artificial rupture of membrane (ARM) and oxytocin induction (aOR 2.07, 95% CI 1.22-3.50, p = 0.0068), lower age (aOR 0.92, 95% CI 0.88-0.97, p = 0.0010) and higher A-LPQ birth pain score (aOR 1.02, 95% CI 1.01-1.04, p = 0.0064) as independent associations with cessation of breastfeeding at postpartum 6-10 weeks, with AUC of the model being 0.72 (95% CI 0.68-0.77). Higher pain experienced during labor is associated with cessation of breastfeeding among several other intrapartum interventions and psychological vulnerabilities. Using risk stratification strategy, breastfeeding support services could be provided to women to optimize successful breastfeeding in the postpartum period.Trial registration: This study was registered on Clinicaltrials.gov NCT03167905 on 30/05/2017.