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Dear Tina
I also feel it is significant that the problems
were highest for the primip many of who may not have another baby or carry the
negative experience into the subsequent pregnancy!
In this age of 1.3 babies per capita
Denise
PS well done on being on the program of the Next
NSW MA State conference
----- Original Message -----
Sent: Sunday, March 23, 2003 4:37
AM
Subject: [ozmidwifery] epidurals and BF
rates...
Hi all....doing the rounds of the journals tonight...found
this interesting snippet...
Yours in reforming midwifery
Tina
Pettigrew.
B Mid Student ACU Melb
http://groups.yahoo.com/group/BMidStudentCollective/
"
As we trust the flowers to open to new
life
- So we can trust birth"
Harriette Hartigan.
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Effect of Labor Epidural Anesthesia on Breast-Feeding of Healthy
Full-
Term Newborns Delivered Vaginally
from Journal of the American
Board of Family Practice
Posted 03/05/2003
Dennis J. Baumgarder, MD,
Patricia Muehl, RN, MSN, Mary Fischer, MS,
Bridget
Pribbenow
http://www.medscape.com/viewarticle/449424
Abstract
and Introduction
Abstract
Background: Epidural anesthesia is commonly
administered to laboring
women. Some studies have suggested that epidural
anesthesia might
inhibit breast-feeding. This study explores the
association between
labor epidural anesthesia and early breast-feeding
success.
Methods: Standardized records of mother-baby dyads representing
115
consecutive healthy, full-term, breast-feeding newborns delivered
vaginally of mothers receiving epidural anesthesia were analyzed and
compared with 116 newborns not exposed to maternal epidural
anesthesia. Primary outcome was two successful breast-feeding
encounters by 24 hours of age, as defined by a LATCH breast-feeding
assessment score of 7 or more of 10 and a latch score of 2/2. Means
were compared with the Kruskal-Wallis test. Categorical data were
compared using the Mantel-Haenszel chi-square test. Stratified
analysis of potentially confounding variables was performed using
Mantel-Haenszel weighted odd ratios (OR) and chi-square for
evaluation
of interaction.
Results: Both epidural and nonepidural anesthesia groups
were similar
except maternal nulliparity was more common in the epidural
anesthesia group. Two successful breast-feedings within 24 hours of
age were achieved by 69.6% of mother-baby units that had had epidural
anesthesia compared with 81.0% of mother-baby units that had not
(odds
ratio [OR] 0.53, P = .04). These relations remained after
stratification
(weighted odds ratios in parenthesis) based on
maternal age (0.52), parity
(0.58), narcotics use in labor (0.49),
and first breast-feeding within 1
hour (0.49). Babies of mothers who
had had epidural anesthesia were
significantly more likely to receive
a bottle supplement while
hospitalized (OR 2.63; P < .001) despite
mothers exposed to epidural
anesthesia showing a trend toward being
more likely to attempt
breast-feeding in the 1 hour (OR 1.66; P
= .06). Mothers who had epidural
anesthesia and who did not breast-
feed within 1 hour were at high risk for
having their babies receive
bottle supplementation (OR
6.27).
Conclusions: Labor epidural anesthesia had a negative impact on
breast-feeding in the first 24 hours of life even though it did not
inhibit the percentage of breast-feeding attempts in the first hour.
Further studies are needed to elucidate the exact nature of this
association.
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