Dear Friends:
    Well, we wouldn't be recommending breast stimulation for high-risk women 
anyway.
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March 2005
Main results
Six trials (719 women) were included.
Analysis of trials comparing breast stimulation with no intervention found a 
significant reduction in the number of women not in labour at 72 hours (62.7% 
versus 93.6%, relative risk (RR) 0.67, 95% confidence interval (CI) 0.60 to 
0.74). This result was not significant in women with an unfavourable cervix. A 
major reduction in the rate of postpartum haemorrhage was reported (0.7% versus 
6%, RR 0.16, 95% CI 0.03 to 0.87). No significant difference was detected in 
the caesarean section rate (9% versus 10%, RR 0.90, 95% CI 0.38 to 2.12) or 
rates of meconium staining. There were no instances of uterine hyperstimulation. 
Three perinatal deaths were reported (1.8% versus 0%, RR 8.17, 95% CI 0.45 to 
147.77).
When comparing breast stimulation with oxytocin alone the analysis found no 
difference in caesarean section rates (28% versus 47%, RR 0.60, 95% CI 0.31 to 
1.18). No difference was detected in the number of women not in labour after 
72 hours (58.8% versus 25%, RR 2.35, 95% CI 1.00 to 5.54) or rates of meconium 
staining. There were four perinatal deaths (17.6% versus 5%, RR 3.53, 95% CI 
0.40 to 30.88).
Authors' conclusions
Breast stimulation appears beneficial in relation to the number of women not 
in labour after 72 hours, and reduced postpartum haemorrhage rates. Until 
safety issues have been fully evaluated it should not be used in high-risk women. 
Further research is required to evaluate its safety, and should seek data on 
postpartum haemorrhage rates, number of women not in labour at 72 hours and 
maternal satisfaction.
--------------------------------------------------------------------------
warmly,

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE,CIMI
Adjunct Faculty, Union Institute and University, Lactation Program
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com

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