Epidurals may shorten breast feeding
Women who have an epidural during labour stop breast
feeding their babies earlier than those who have a drug-free birth, an
Australian study shows.
The West Australian study, published in the Australian and New Zealand Journal
of Obstetrics and Gynaecology, observed almost 1,000 first-time mums at a major
public obstetric hospital in Perth
between 1997 and 1999.
"Epidural analgesia was found to be associated with shorter breast-feeding
duration," the report concluded.
It found that women who had an epidural had 1.4 times the risk of breastfeeding
for less than six months than those who did not use any pharmacological pain
relief.
The researchers, from the University of Western Australia, the Women and
Infants Research Foundation and King Edward Memorial Hospital, reported that
women who did not receive any pain relief breast fed for significantly longer
than women who were given a narcotic like pethidine or an epidural.
Breast feeding time was shorter for women who only had narcotic pain relief but
shortest for those given an epidural.
The study said epidurals, a type of anaesthetic block injected into the spine,
had not been shown to have any major adverse effects on babies, but could
produce subtle neurobehavioural depression.
"It has been suggested that these mild effects are sufficient to impede
the successful initiation of breast feeding, leading to early, unplanned
cessation of breast feeding," the study notes.
However, the authors said it is also possible that the findings reflected
maternal coping styles.
For example, a woman with a higher pain threshold during labour may be able to
cope better with breast feeding difficulties after birth.
A total of 992 women were recruited for the trial and 690, or 70 per cent,
received an epidural.
At two months, 78 per cent of women who had no pain relief were still
breastfeeding, compared to 68 per cent of women who had narcotic pain relief
and 62 per cent of women who had epidurals.
Only 60 per cent of women who had both forms of pain relief were still
breastfeeding at two months.
The study said there has a high rate of epidurals for the women in the study and
the early cessation of breast feeding in this group was concerning.
More research was needed to explain the underlying factors, the study
concluded.
no reference given
