Useful information on the complex relationship between epidural and breastfeeding your baby, with advice on the possible side effects of receiving this anaesthesia injection.
The influence of epidurals on breastfeeding is a subject that has recently received lot of media attention. The publication of a study linking breastfeeding difficulties in newborns to the use of these pain relieving drugs during labour has again bought this debate into the public eye.
As epidurals are administered during 20 - 40% of childbirths in the UK, these claims have the potential to influence the birthing decisions of a lot of mums-to-be. For this reason it is important to fully understand the options available when making a choice about the pain relief you will receive during labour.
Epidurals became popular during the 80's when they were hailed as the answer to a pain free birth. Their superior pain-relieving effect is a result of the combination of an opiate (such as fentalyn) with a local anaesthetic. When an epidural is required an anaesthetist administers the drugs via a catheter placed in the epidural space near the base of the spinal cord. This numbs the nerves that bring sensation to your lower body, relieving labour pain.
The study recently published caused a stir as there has been relatively little research on the effect of epidurals on infants. Although previous research does provide some support for a negative link between epidurals and initial breastfeeding behaviour, each study had problems, thus preventing any firm conclusions from being drawn on their basis.
The breastfeeding problems cited in these studies are based on a newborn's inability to coordinate their sucking behaviour and includes an inability to latch and suckle without help. As the studies suggest that this uncoordinated behaviour is only found in infants whose mothers received an epidural during the birth, a cause and effect relationship is often assumed.
Although this 'sleepy' behaviour may be attributable to the effects of the drugs administered during an epidural crossing from the mother's bloodstream to the baby's via the placenta (as suggested), there may be other explanations for these findings. For instance, factors such as the type of birth, problems during birth, the development of the infant, the physical and mental state of the mother and the surrounding environment are all likely to contribute to the establishment of initial breastfeeding behaviour.
The majority of studies in this area found no lasting effects of an epidural on breastfeeding (as the effect is said to diminish after the drugs have passed out through the infants system). Although the recently published study did find a link between initial breastfeeding behaviour and continuation of breastfeeding at 24 weeks, they did not look at the reasons of the mother for continuing/discontinuing breastfeeding at this stage. For this reason it is impossible to suggest that this finding is a direct result of the epidural; it may be that mothers who choose a natural birth are simply likely to breastfeed for longer.
Although the empirical evidence does suggest that there may be a link between epidurals and delayed development of the sucking reflex in newborns it is by no means conclusive. There are too many factors which are uncontrolled or unaccounted for to draw a conclusion either way. Consequently further, more controlled research is necessary before this is possible.
As a parent-to-be you should ensure that you have all of the information you need about the choices available to you when formulating a birth plan. If you are concerned about having an epidural you should discuss this with your health care practitioner. However, many alternate pain relief options are available, including hydrotherapy, visualisation, movement and breathing techniques. Having a doula present throughout the birth is also said to reduce the need for anaesthetic intervention.
Whatever you choose the decision is ultimately yours and one that you should be happy, comfortable and relaxed with as this will help to ensure that you give your baby the best start in life by having a positive birthing experience.
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