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Objective: To explore the relationship of early breastfeeding behaviors after Cesarean section (CS) to long-term breastfeeding outcome. Materials and Methods: A total of 648 healthy breastfeeding primiparas (333 delivered by CS, and 315 by vaginal birth) were recruited from three teaching hospitals using probability proportional to size sampling method. Data of the first 3 days breastfeeding behaviors, including breastfeeding initiation, frequency and duration, formula supplement, and infant sucking performance, were gathered. Ordinal cumulative odds logistic regression model were conducted to explore the effect of CS on breastfeeding outcome at fifth day, and first, fourth, and sixth month before and after adjusting for the variants of early breastfeeding behaviors. Results: The unadjusted odds ratios (ORs) for lower breastfeeding rates associated with CS were 2.11 (95% confidence interval [CI]: 1.58-2.81), 2.67 (95% CI: 1.96-3.63), 1.60 (95% CI: 1.19-2.15), and 1.36 (95% CI: 1.01-1.83) at the fifth day, and first, fourth, and sixth month. After adjusting for the early breastfeeding behaviors, the negative effect of CS on long-term breastfeeding was attenuated, and no longer significant at fifth day (OR: 1.01, 95% CI: 0.70-1.47) and fourth month (OR: 1.13, 95% CI: 0.79-1.62) and sixth month (OR: 0.81, 95% CI: 0.56-1.17). Conclusions: CS had a detrimental effect on early breastfeeding behaviors and long-term breastfeeding outcomes. CS per se is not a negative factor, but rather those infants who have feeding difficulties in the immediate postpartum period have long-term problems.

Objective: To compare the maternal and neonatal outcomes of twin pregnancies between vertex and nonvertex presentations of the second twin in vaginal delivery. Methods: In this unicentric retrospective cohort study, we collected data from 213 cases of vaginal twin deliveries from January 2016 to July 2020. Participants were divided into the vertex‐vertex presentation group (VV) and vertex‐breech presentation group (VB). Data on maternal and neonatal outcomes were compared between groups. Results: Among the 213 mothers and 426 infants (213 twin pairs), there were 140 women in the VV group and 73 women in the VB group (65.73% vs. 34.27%). Infants in the VB group had a higher incidence of admission to NICU (51.43% vs. 68.49%, p = 0.017), lower 1‐min (11.43% vs. 28.77%, p < 0.001) and 5‐minute Apgar scores (1.43% vs. 4.11%, p = 0.043) for the second twin. However, after the adjustment for sex of the twin, birth weight, chorionicity, and gestational age, the greater risk of admission to NICU and low 5‐min Apgar score was no longer significantly different. Conclusion: VB twins are at no greater overall risk of a poor outcome due to breech presentation in the second twin. However, the presentation of the second fetus represents a risk factor for a low 1‐min Apgar score. Obstetricians and midwives should consider appropriate interventions for second twins who present breech versus vertex. [ABSTRACT FROM AUTHOR]

Aim: Unpredictable nature of infant sleep–wake cycles go against that of the adult sleep. Maternal sleep quality is acknowledged as a main factor to postpartum fatigue. This study explored the effects of infant sleep patterns on maternal postpartum fatigue. Methods: A total of 319 mothers of infants from two teaching hospitals in the Nantong City were enrolled. Maternal fatigue status and infant sleep patterns were assessed by the Fatigue Scale (FS‐14) and the Brief Infant Sleep Questionnaire (BISQ). Generalized estimating equation analyses were perform to explored the effect of infant sleep patterns on maternal fatigue. Results: Sleep‐onset time later than 10 p.m., and nocturnal wakefulness more than 60 min were risk factors of postpartum fatigue. After controlling the confounding variables, infant sleep patterns were still the determinant factors of postpartum fatigue. Conclusion: Infant sleep pattern is a factor of maternal postpartum fatigue. It is recommended to promote infant sleep so as to improve maternal sleep quality and finally alleviate postpartum fatigue. [ABSTRACT FROM AUTHOR]