Life> Health

Breastfeeding difficulties linked to mothers who have epidurals

By Julie Wheldon (Daily Mail)
Updated: 2006-12-11 15:21

The 416 women who had the pain-killing injection were also twice as likely to have stopped breast-feeding before six months compared to those who had no analgesia.

Even taking into account the woman's age and education, they found 72 per cent of those who had no pain-killing treatments during labour were still breast-feeding at 24 weeks compared to 53 per cent who had.

The epidurals contained two chemicals called bupivacaine and fentanyl, which is an opioid.

Lead researcher Siranda Torvaldsen from the University of Sydney, concluded that women who had an epidural, a general anaesthetic or a caesarean section for the birth of their baby were more likely to have problems breast-feeding.

"Partial breast-feeding in the first week may be indicative of difficulty establishing breast-feeding and is important because these women are at increased risk of stopping breast-feeding altogether," she said.

She said it was hard to evaluate exactly why epidurals may affect breast-feeding.

But pointed to a recent study which found women given the highest dose of the chemical fentanyl were more likely than others to have stopped breast-feeding at six weeks.

She concluded: "It is important that women who are at higher risk of breast-feeding cessation are provided with adequate breast-feeding assistance and support both in the initial postpartum period and the following few months."

Sue Jordan of Swansea University said, although only circumstantial, 'the evidence from this paper would suggest that opioids affect infant feeding.'

Writing in the same journal, she said many social, physical and medical reasons can lead to women not breast-feeding but there has been greater focus recently on a possible link to medications.

However it was very difficult to carry out controlled trials since that would mean women on the placebo would not get the pain-killers they wanted during labour.

She therefore concluded that, since labour without any possibility of pain relief is not an option, additional help with feeding should be offered to women who have had high doses of opioid drugs.

They should also be given information to help them understand why they might be having feeding problems, she advised.

Rosie Dodds, of the National Childbirth Trust, said the new study added to mounting evidence of how painkillers used during labour might affect a baby's sucking ability.

"Women considering pain relief really should be informed at the antenatal stage about the advantages and disadvantages of epidurals so they are aware of the implications of any decisions they make," she said.

"If they do have an epidural and they feel feeding is not going well, they need to ask for help and not think there is something wrong with them."