----- Original Message ----- 
From: Barbara Glare & Chris Bright 
To: ozmidwifery@acegraphics.com.au 
Sent: Monday, December 11, 2006 9:13 AM
Subject: [ozmidwifery] Epidurals and Breastfeeding


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http://www.theaustralian.news.com.au/story/0,20867,20905801-2702,00.html

Epidural babies can't get grip on what's breast
David King 
December 11, 2006
WOMEN who give birth with the aid of pain-relieving epidurals find it harder to 
breastfeed than those who give birth naturally, an Australian study has found.
The research suggests some of the drugs used in epidurals make their way into 
babies' bloodstreams, subtly affecting their brains and development for weeks 
afterwards -- including making them less willing to breastfeed. The study by 
University of Sydney epidemiologist Siranda Torvaldsen adds to a growing body 
of knowledge that makes a link between the use of the pain-killing drug 
fentanyl in epidurals and problems with breastfeeding. During an epidural a 
catheter is inserted into the spine to allow the infusion of pain-killing 
drugs. These deaden the nerves that relay sensations of pain from the lower 
body. 

In a commentary on the research, published today in International Breastfeeding 
Journal, British scientist Sue Jordan suggests the impact of epidurals on 
breastfeeding should be officially classed as an "adverse drug reaction". Dr 
Jordan, senior lecturer in applied therapeutics at Swansea University, said 
women given the infusions should be offered extra support to stop their infants 
being "disadvantaged by this hidden, but far-reaching, adverse drug reaction". 

Dr Torvaldsen and her colleagues studied 1280 women who had given birth in the 
ACT, of whom 416 had an epidural. They found that 93 per cent of the women 
breastfed their baby in the first week, but those who had received epidurals 
generally had more difficulty in the days immediately after birth. 

By the time six months had passed, the women who had been given epidurals were 
twice as likely to have stopped breast-feeding, even after allowing for factors 
such as maternal age and education. The authors suggest the most likely cause 
of the problem was fentanyl, an opioid widely used as one of the components of 
epidurals. Such drugs pass quickly into the bloodstream and easily cross the 
placenta to reach the unborn baby. 

Dr Torvaldsen said she conducted the research after speaking to lactation 
consultants who had noticed that since the addition of fentanyl in epidurals 
they had seen more women having problems breastfeeding. 

She said her research added to other studies in the area, particularly a 
Canadian study that examined fentanyl dosages and breastfeeding outcomes. The 
Canadian study of 177 mothers found they were less likely to be breastfeeding 
if they had been given an epidural with fentanyl. Joy Heads, a lactation 
consultant at Sydney's Royal Hospital for Women, said similar problems had been 
seen when the pain-killer pethidine had been given to mothers in late stages of 
labour. 

She said some newborn babies had lost their "sucking co-ordination" if the 
mother had an intra-muscular injection of the pethidine in the last half hour 
of a normal delivery. 

Additional reporting: Sunday Times

Barb Glare
Counsellor, ABA Warrnambool Group
Mum of Zac, 13, Dan, 11, Cassie, 8 and Guan 3
Director, ABA and Mothers Direct
[EMAIL PROTECTED]
www.mothersdirect.com.au
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