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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