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Date: | Mon, 5 Dec 2005 23:52:53 EST |
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Regarding Medications and Cesarean deliveries: a report from the CS central
of South Florida. I truly see the nearly 60% cesarean rate that we have
here not affected by the prescribed meds post delivery as influencing
breastfeeding, but rather the mind set of the individual mother. Our patients receive
Astromorph 98% of the time. We see tremendous amounts of nausea and vomiting
which I often feel is associated with long periods of fasting either while
in labor or waiting for surgery (NPO from midnight is too long for the 4 PM
surgical patient). This post surgery nausea makes breastfeeding difficult and
those meds often make the patient groggy.
We use Percocet and Ibuprofen 600 mg primarily for pain management. Our
patients will ask 9 out of 10 times how this will effect their ability to
breastfeed. But it's their mental attitude of "no milk" and sending the baby to
the nursery for the night and allowing the nursery staff to give formula or
they themselves thinking they need to give formula because the baby is still
acting hungry after feeding, that are the real culprits in derailing the
breastfeeding experience.
The mothers who request their pain med every 4 hours or less and have no
coping skills will usually not cope with baby who either demands frequent long
feeds or the one who has a poor latch causing sore nipples. She will often
revert to bottle feeding to give herself a break.
Moms who usually get up and moving and use their meds as needed and allow
their babies to set the pace and use skin to skin seem to do well.
Different women respond differently to different pain management tools and
this can play into the breastfeeding equation but its only a very small part of
the picture. I think its is more aligned to the "I'll try versus the I will
breastfeed" expectation of the mother. I always remind my patients that
they need to be comfortable to be able to handle and work with the baby and pain
medication is a tool just like a pillow and comfortable chair or bed.
Leanne Jewell RNC, IBCLC, LCCE, FACCE
SFL
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