Epidurals: Can they impact breastfeeding?

Lactation consultants have long maintained that newborns whose mothers had epidurals have problems suckling at the breast. Now, a Swedish study has produced evidence that ‘caine drugs, the family of anesthetics used in epidurals, do, in fact, profoundly disturb instinctive newborn breastfeeding behavior.

The study compared the newborns of ten women who received no pain medication, with those of six women who received only mepivacaine in a pudendal block (an injection through the wall of the vagina on either side to numb the vaginal canal for birth) and twelve women who received either epidural bupivacaine, or a narcotic, or some combination of narcotic, pudendal block, and epidural block. All participants were healthy, full-term babies with high Apgar scores at birth. It should be noted that ‘Caine anesthetics, whether given as a pudendal block, epidural block, or local injection for an episiotomy, enter the mother’s circulation and cross the placenta.

Newborns were quickly dried, laid on their bellies upon their mother’s chest and covered with a blanket, leaving the head and arms exposed. A sensor to measure body temperature was placed on their backs. Researchers videotaped the baby’s behavior for the first two hours after birth and analyzed the videotapes. Those analyzing the videotapes did not know to which group the infant belonged.

Previous studies had established that the infants of unmedicated mothers follow a predictable sequence of massaging the mother’s breast with their hands, searching for the nipple, self-latching, and suckling, a process that generally took about an hour.

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