Dear Marie:
I enjoyed your webpage, and checked out the epidural page.
I thought that you might be interested in this study. The hospital where it
was conducted has 50 IBCLC on staff, lacks a nursery, and does not use
formula or pacifiers routinely.
The findings contradict what I like to believe. Anecdotally, I have
learned from staff at a Baby Friendly Hospital in the south that their
epidural rate is quite high, and so is their breastfeeding rate.
We don't know about the long term impact on breastfeeding duration
though. At present, it seems to me that, much as I dislike it, epidurals only
are a threat to breastfeeding in facilities that lack breastfeeding support.
According to the anesthesiologists, the national epidural rate is a
little of 60%; I think that was findings from 1998.
Birth 26 (2), 83-88
© Blackwell Science Inc
Effect of Labor Analgesia on Breastfeeding Success
Stephen H. Halpern, MD, FRCPC, Tracey Levine, BS, Donna B. Wilson, MN, Jo
MacDonell, MScN, IBCLC, Sandra E. Katsiris, MD, FRCPC and Barbara L.
Leighton, MD, DABA
Background: The effect of labor analgesia on breastfeeding success is not
well defined. Some authors have hypothesized that labor analgesia may affect
lactation success. The purpose of this observational study was to determine
if intrapartum analgesia influenced breastfeeding success at 6 weeks
postpartum in a setting that strongly supported breastfeeding. Methods:
Healthy women with uncomplicated term pregnancies who planned to breastfeed
consented to a telephone interview. We recorded demographic data, labor
induction status, delivery mode, and analgesic medications. At between 6 and
8 weeks postpartum, patients were asked to describe breastfeeding use,
problems encountered, solutions derived, sources of support and information,
and satisfaction. We created a logistic regression model using intrapartum
analgesia information and controlling for demographic factors previously
correlated with lactation success. Results: We enrolled 189 women, contacted
177 women postpartum, and obtained complete data on 171 women. Of these, 59
percent received epidural analgesia, 72 percent breastfed fully, and 20
percent breastfed partially (> 50% of infant nutrition) at 6 weeks
postpartum. After controlling for demographics and labor outcome, we could
not demonstrate a correlation between breastfeeding success at 6 to 8 weeks
and labor analgesia. Conclusions: In a hospital that strongly promotes
breastfeeding, epidural labor analgesia with local anesthetics and opioids
does not impede breastfeeding success. We recommend that hospitals that find
decreased lactation success in parturients receiving epidural analgesia
reexamine their postdelivery care policies.
(BIRTH 26:2 June 1999)
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI
craniosacral therapy practitioner; childbirth educator
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporting the WHO Code and the Mother Friendly Childbirth Initiative
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI
craniosacral therapy practitioner; childbirth educator
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporting the WHO Code and the Mother Friendly Childbirth Initiative
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