Caesarean Section is Associated with Reduced Early Lactation Performance and Serum Prolactin Levels Compared to Vaginal Delivery: A Prospective Observational Study

Background: Breastfeeding is essential for neonatal nutrition, immunity, and maternal health, with early initiation influenced by mode of delivery and hormonal factors such as prolactin. This study aimed to compare breastfeeding effectiveness and serum prolactin levels in women undergoing normal vaginal delivery (NVD) and caesarean section (CS) using the LATCH scoring system. Methods: This prospective observational study included 800 postpartum women (400 NVD, 400 CS) in a tertiary care hospital in central India over 18 months. Breastfeeding effectiveness was assessed using the LATCH score at 1 hour and 24 hours postpartum. Serum prolactin levels were measured at the same time points. Sociodemographic, obstetric, and clinical variables were recorded. Statistical analysis included t-tests, chi-square tests, correlation, and regression models. Results: Baseline characteristics differed significantly in age and education between groups. At 1-hour postpartum, mean LATCH scores were comparable between NVD and CS groups (4.98 ± 1.81 vs. 4.96 ± 1.74; p = 0.889). At 24 hours, NVD had significantly higher LATCH scores than CS (5.99 ± 1.89 vs. 5.05 ± 1.78; p <0.001). Serum prolactin levels were significantly higher in NVD at both 1 hour (304.30 ± 21.10 vs. 264.74 ± 34.24 ng/mL) and 24 hours (346.75 ± 30.44 vs. 322.34 ± 36.26 ng/mL; p < 0.001). A weak positive correlation was observed between 24-hour LATCH scores and prolactin levels. Mode of delivery was an independent predictor of prolactin levels but not LATCH score. Conclusion: Caesarean delivery is associated with reduced early breastfeeding performance and lower serum prolactin levels compared to vaginal delivery, particularly evident by 24 hours postpartum. Targeted lactation support is recommended for caesarean-delivered mothers to improve breastfeeding outcomes.