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Epidurals and Breast Feeding

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I wrote thank you notes to the anesthesiologists who gave me my epidurals. Seriously. After both kids were born, I sent the doctors birth announcements and thanked them profusely for making my labor more comfortable. I’m a wimp, and there was no way I was going to “just say no” to drugs. I am the total opposite of my friend who had three babies at home, on the sofa and in an inflatable swimming pool.
So, I took particular interest in the results of a new study which says that women who have epidurals have more trouble breast feeding. Here’s a section from the study’s Abstract published in The International Breastfeeding Journal:
Background
Anecdotal reports suggest that the addition of fentanyl (an opioid) to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. The aim of this paper is to determine any association between epidural analgesia and 1) breastfeeding in the first week postpartum and 2) breastfeeding cessation during the first 24 weeks postpartum.

Conclusions
Women in this cohort who had epidurals were less likely to fully breastfeed their infant in the few days after birth and more likely to stop breastfeeding in the first 24 weeks. Although this relationship may not be causal, it is important that women at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support.

Note the use of the word “opioid” above. The researchers were basically investigating whether the epidural made the babies so sleepy that they had trouble eating. (This is something I had heard about anecdotally before I had our kids). The researchers conclude that this is a possibility. But that it’s also likely that there could be a link between the choices women make about pain management and breast feeding.
As for me, I had epidurals and I breast fed. I was fortunate that both of my kids picked up on the boob thing pretty quickly. I breast fed The Bortski for eleven months, and The Bear and I are now going strong on our eighth month of boob milk.
Why was I able to succeed and some people have trouble? Quite honestly I have no idea. Maybe it’s just been just good luck. Or maybe it was my obsessive nature, which made me religiously feed the babies every two hours for a couple of weeks after birth. I remember doing everything within my power to wake The Bear when he was sleepy. I stripped him down to his diaper. I tickled his nose and lips. I pinched– or more accurately– dug my fingernail into the heel of his foot. I remember feeling like I had reached a milestone when he ate for more than 5 minutes without falling back asleep.
Perhaps these researchers are onto something that OB’s and anesthesiologists need to investigate further. Quite honestly, I don’t know anything about the medical aspects of epidurals. All I know is that without one, I might have bit my husband’s head off (oh, actually I did that when he was chewing nuts while I was having a contraction). I also threw up all over him before I got my epidural.
So, I really hope this study doesn’t deter women who plan to breast feed from getting pain relief if they really want it. There’s no medal for being a tough guy during labor. If you need help, get it. And as I tell all my friends who are about to have a baby, if you want an epidural, ask for it “early and often.” There’s no telling how long it will take for the doctor to show up once you request the epidural. So repeat after me…”early and often.”
And for goodness sake, if you have to have pitocin to get your labor going, get the epidural before the pitocin. With The Bortski, I had the pitocin first, epidural second. The pitocin made the contractions so unbearable I had a hard time staying still when they were trying to insert the epidural needle. With The Bear, I got the epidural first, pitocin second. Now that, was sheer bliss. And if you’re wondering about– or maybe passing judgment on– my decisions, please note that I had preeclampsia so my doctors had to induce me both times.
One more thing… send a Holiday card to your doctors…they’d probably be happy to hear from you.
Plus, to hear what other bloggers have to say about this study, check out The Lactivist and Breastfeeding123.
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4 Responses to “Epidurals and Breast Feeding”

I have nursed all 3 of my children and have had 0 epidurals. Most of the women that I know that are or have breats-fed their babies have not had epidurals. I recently heard a stat. that said 70% of moms in this country are working moms. While it’s possible, most do not breast feed once they go back to work. My guess would be that alot of working women want the epidural, and then are back to work by the 24th week so they are no longer nursing, if they did at all. Just my opinion. You, obviously would be the exception.

No judgement passed. :) You’re great just to mention your personal experience as we are all different and have experienced differetnly. The great thing is that you did breastfeed even though you had meds. so many will go through this as I did as well. Women need wonderful sites like yours.
respectfully,
Evie

I think they are on to something here. With DD#1, we had problems breastfeeding b/c she wouldn’t wake up for the first 48 hours to eat. The nurses told me it was normal and that it was because of the epidural. My second daughter was born at home and latched on right away.

Part of the coorelation may be that often after a women receives an epi, she’s often put on pitocin to keep labor going (being stationary tends to slow down labor, as moving and being vertical speeds it up). Pitocin is an anti-diuretic, and causes the breast tissue surrounding the milk glands/ducts to retain water and literally makes it harder for the breast to produce and let down milk. The IV that accompanies the epi also has this effect on the body.

FYI, one thing (besides avoiding an epi and pit) that you can do to relieve that side effect (our body wasn’t *meant* to produce milk with that much fluid in our soft tissue!), is to perform reverse pressure softening on your own breasts. It sounds complicated, but it’s super simple, and not uncomfy. :O)

here’s a decent vid showing how. :O)
http://www.5min.com/Video/How-to-Use-Reverse-Pressure-Softening-During-Engorgement-106182017

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