Hello. My name is Kelli Olerud and I am a junior nursing student at the
University of North Dakota. Currently I am taking a childbearing class and
am also anxiously awaiting the delivery of my expecting client. I chose to
join this listserve because I have always wanted to work on the OB floor
and am a believer in the many benefits of breastfeeding. I have recently
learned that women that receive epidural analgesia can experience some
difficulty in getting their infant to initiate breastfeeding because the
drugs crossing over to the baby and effecting the infants ability to feed.
I have researched this and found rather conflicting data.
According to Radzyminski (2002) the reason that epidural analgesia
could pose a concern with the infant is that the combination of medications
used in the epidural are able to cross the placenta which can depress
reflexes for feeding including rooting, sucking, and swallowing. However,
the results of their study do not indicate any significant differences in
the breastfeeding behaviors of infants born to mothers who received
epidural analgesia and those infants born to those mothers who did not.
In the study by Halpern et al (1999) they found that epidural analgesia had
no effect on breastfeeding both in the hospital and postpartum. However,
according to Riordan et al. (2000), they found that infants that were born
to unmedicated mothers had significantly higher suckling scores as opposed
to those infants born to medicated mothers. The conclusions from these
studies do point toward a relationship between the use of epidural
analgesia and breastfeeding, indicating evidence that there is indeed a
connection between the use of epidural analgesia and the ability of the
newborn to breastfeed.
The article by Chang and Heaman (2005) states that although there is
research out there that suggests the possibility of epidural analgesia to
negatively affect the ability of the newborn to breastfeed, this
information, however, is inconclusive. This research study by Chang and
Heaman (2005) concluded that the infants whose mothers received epidural
analgesia were no more or less likely to be affective in the initial
breastfeeding when compared with those infants whose mothers did not
receive epidural analgesia.
My questions are these: What are being seen in clinical practice? Is there
a connection in the use of epidural analgesia and the initiation of
breastfeeding? Is there is certain combination of epidural analgesia that
causes this more than another?
Kelli Olerud, SN
University of North Dakota
References:
Chang, Z.M., and Heaman, M.I. (2005). Epidural analgesia during labor and
delivery: Effects on the Initiation and Continuation of Effective
Breastfeeding. J Hum Lact, 21(3), 305-313.
Halpern, S.H., Levine, T., Wilson, D.B., MacDonell, J., Katsiris, S.E., and
Leighton, B.L. (1999). Effect of labor analgesia on breastfeeding success.
Birth. 26, 83-88.
Radzyminski, S. (2002). The effect of ultra low dose epidural analgesia on
newborn breastfeeding behaviors. Journal of Obstetric, Gynecologic, and
Neonatal Nursing, 32(3), 322 -331.
Riordan, J., Gross, A., Angeron, J., Krumwiede, B., and Melin, J. (2000).
The
effect of labor pain relief medication on neonatal suckling and
breastfeeding duration. Journal of Human Lactation. 16, 7-12.
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