Labor Medication and Breastfeeding

Making a birth and postpartum plan can be overwhelming. So many choices, options, and consequences. You ask yourself, "will all this research and planning really have a tangible outcome?" If breastfeeding is a goal, there is a recent observational study that says "yes" it may indeed make a difference. 

Kajsa Brimdyr, PhD, CLC has recently published a study showing the association between Fentanyl epidurals and suckling challenges in infants in the first hour after birth. There are many medications that can be in an epidural, but fentanyl is one that specifically hinders the newborn infant's ability to suckle at the breast immediately after birth. Fentanyl is a highly lipid soluble opioid which easily crosses the placenta to the baby. Infants go through 9 distinct stages after birth leading up to breastfeeding which can have some really important implications if those stages are hindered.

Brimdyr observed the 9 stages of infant behavior in babies who were exposed to fentanyl via epidural. She noticed that infants exposed to fentanyl were less likely to suckle and breastfeed one hour after birth. 

So...

"We have known for some time that early initiation helps to establish exclusive breastfeeding – a life-saving practice. These new findings also confirm that getting an early start to breastfeeding boosts child survival in its own right and that the protective benefit extends well beyond the first month, until the age of 6 months."  UNICEF 2016

This study demonstrates that an epidural that contains fentanyl could very well effect long term goals of breastfeeding.

 Here is a video that summarized Brimdyr's findings:

What does this mean for you?

• Plan what type of birth you want to have taking into consideration your breastfeeding goals.
• Be informed about what type of medication is typically used in your hospital's epidurals.
• Advocate for yourself and your birth medication if you plan on an epidural (or are open to one).