Breastfeeding may protect against chronic pain after Caesarean section

C-sections account for around a quarter of all births in the UK, USA, and Canada. Chronic pain (lasting for more than 3 months) after C-section affects around 1 in 5 mothers. It is widely accepted that breast milk is the most important and appropriate nutrition in early life, and WHO, the UK Department of Health, and US Department of Health and Human Services all recommend exclusive breastfeeding up to 6 months of age. But until now, little has been known about the effect of breastfeeding on a mother's experience of chronic pain after C-section.

The study, by Dr Carmen Alicia Vargas Berenjeno and colleagues from the Hospital Universitario Nuestra Señora de Valme in Sevilla, Spain, included 185 mothers who underwent a C-section at the hospital between January 2015 and December 2016. Mothers were interviewed about breastfeeding patterns and the level of chronic pain at the surgical site in the first 24 and 72 hours after C-section, and again 4 months later. The researchers also looked at the effect of other variables on chronic pain including surgical technique, pain in the first 24-72 hours, maternal education and occupation, and anxiety during breastfeeding.

Almost all (87%) of the mothers in the study breastfed their babies, with over half (58%) reporting breastfeeding for two months or longer. Findings showed that around 1 in 4 (23%) of the mothers who breastfed for two months or less still experienced chronic pain in the surgical site 4 months post-op compared to just 8% of those who breastfed for 2 months or longer. These differences were notable even after adjusting for the mother's age. Further analysis showed that mothers with a university education were much less likely to experience persistent pain compared to those who were less well educated. The researchers also found that over half (54%) of mothers who breastfed reported suffering from anxiety.

The authors conclude: "These preliminary results suggest that breastfeeding for more than 2 months protects against chronic post-caesarean pain, with a three-fold increase in the risk of chronic pain if breastfeeding is only maintained for 2 months or less. Our study provides another good reason to encourage women to breastfeed. It's possible that anxiety during breastfeeding could influence the likelihood of pain at the surgical site 4 months after the operation."

The authors are currently analysing additional data from women interviewed between November 2016 to January 2017, which, when combined with data from all the other women, shows that anxiety is associated with chronic post Caesarean pain in a statistically significant way.