All drugs administered to laboring women reach the mother's blood stream
then the baby via the placenta. ALL of them.

Therefore, all drugs given to the laboring woman reach the baby, regardless
of where they are administered - locally, epidural, IV, by general
anesthesia. 

All are highly lipid soluble and affect the pain centers in the brain,
therefore distribute to the brains of the mother and baby quickly, like in
15 seconds to 2 minutes. 

This is NOT new information.  Here are some key references from the OB &
anesthesia literature:

Caton D, Corry MP, Frigoletto FD, et al. The nature and management of labor
pain: executive summary. Am J Obstet Gynecol. May 2002;186(5 Suppl
Nature):S1-15.

Loftus JR, Hill H, Cohen SE. Placental transfer and neonatal effects of
epidural sufentanil and fentanyl administered with bupivacaine during labor.
Anesthesiology. Aug 1995;83(2):300-308. 

Ransjo-Arvidson AB, Matthiesen AS, Lilja G, Nissen E, Widstrom AM,
Uvnas-Moberg K. Maternal analgesia during labor disturbs newborn behavior:
effects on breastfeeding, temperature, and crying. Birth. Mar
2001;28(1):5-12.

Nissen E, Lilja G, Matthiesen AS, Ransjo-Arvidsson AB, Uvnas-Moberg K,
Widstrom AM. Effects of maternal pethidine on infants' developing breast
feeding behaviour. Acta Paediatr. Feb 1995;84(2):140-145.


Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre Ltd.
6540 Cedarview Ct, Dayton OH 45459 USA
(937) 438-9458 / fax (937) 438-3229
www.BFLRC.com

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