RE: [ozmidwifery] FW: Epidurals & breastfeeding

[Julie Clarke]

Thanks Marilyn have you read of any other connection between epidurals and b/f probs? Hug Julie   Julie Clarke CBE Childbirth and Parenting Educator ACE Grad-Dip Supervisor NACE Advanced Educator and Trainer   Transition into Parenthood 9 Withybrook Pl Sylvania NSW 2224. T. (02) 9544 6441 F. (02) 9544 9257 Mobile 0401 2655 30 email:  [EMAIL PROTECTED] www.transitionintoparenthood.com.au   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Marilyn Kleidon Sent: Sunday, 26 October 2003 10:22 AM To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] FW: Epidurals & breastfeeding   Julie:   I read that abstract recently, think it was on medscape, not sure.  The trouble with studies and stats like that is that they lump everyone together. It may be generally true that women who choose and achieve a drug free birth also plan to breastfeed for at least 12 months or longer but  does anyone really know. It may also be true that a woman who plans a  drug free birth but ends up with epidural and "the works" may be super determined to succeed at breast feeding and do the same yet someone who chooses to have the epidural in the carpark, so to speak, is happy if they breastfeed for the first couple of weeks or I could have it all about face. I had read a study similar to that 27 yrs ago when i was pregnant with my first daughter. The study was done in some Sydney hospital and indicated that women who had birth trauma: forceps, emergency c/s, were less likely to bond with their babies and less likely to b/f. I resolved there and then I was gonna bond and b/f no matter what and I did. But it could have sowed the seeds of doubt in someone else and also perhaps in staff. Anyway, I think we don't really know why at least not on an individual level because I think there are multiple answers.   marilyn     ----- Original Message --- From: Julie Clarke To: Ozmidwifery Mailing List Sent: Friday, October 24, 2003 8:58 PM Subject: [ozmidwifery] FW: Epidurals & breastfeeding   Hi I have been sent the information below about a study in WA – Has anyone else heard of this study before? I’m just wondering if it is true? Any comments? Regards Julie     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