Effect of Labor Analgesia on Breastfeeding Success

Authors

  • Stephen H Halpern MD, FRCPC,

    1. Stephen Halpern, Tracey Levine, Donna B. Wilson, and Sandra E. Katsiris are in the Department of Anesthesia, University of Toronto, Women's College Hospital, Toronto. Jo MacDonell is in the Faculty of Nursing, University of Toronto. Barbara Leighton is in the Department of Anesthesiology, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania and is the Visiting Professor of Obstetrical Anesthesia, Center for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada.
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  • Tracey Levine BS,

    1. Stephen Halpern, Tracey Levine, Donna B. Wilson, and Sandra E. Katsiris are in the Department of Anesthesia, University of Toronto, Women's College Hospital, Toronto. Jo MacDonell is in the Faculty of Nursing, University of Toronto. Barbara Leighton is in the Department of Anesthesiology, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania and is the Visiting Professor of Obstetrical Anesthesia, Center for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada.
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  • Donna B Wilson MN,

    1. Stephen Halpern, Tracey Levine, Donna B. Wilson, and Sandra E. Katsiris are in the Department of Anesthesia, University of Toronto, Women's College Hospital, Toronto. Jo MacDonell is in the Faculty of Nursing, University of Toronto. Barbara Leighton is in the Department of Anesthesiology, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania and is the Visiting Professor of Obstetrical Anesthesia, Center for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada.
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  • Jo MacDonell MScN, IBCLC,

    1. Stephen Halpern, Tracey Levine, Donna B. Wilson, and Sandra E. Katsiris are in the Department of Anesthesia, University of Toronto, Women's College Hospital, Toronto. Jo MacDonell is in the Faculty of Nursing, University of Toronto. Barbara Leighton is in the Department of Anesthesiology, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania and is the Visiting Professor of Obstetrical Anesthesia, Center for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada.
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  • Sandra E Katsiris MD, FRCPC,

    1. Stephen Halpern, Tracey Levine, Donna B. Wilson, and Sandra E. Katsiris are in the Department of Anesthesia, University of Toronto, Women's College Hospital, Toronto. Jo MacDonell is in the Faculty of Nursing, University of Toronto. Barbara Leighton is in the Department of Anesthesiology, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania and is the Visiting Professor of Obstetrical Anesthesia, Center for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada.
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  • Barbara L Leighton MD, DABA

    1. Stephen Halpern, Tracey Levine, Donna B. Wilson, and Sandra E. Katsiris are in the Department of Anesthesia, University of Toronto, Women's College Hospital, Toronto. Jo MacDonell is in the Faculty of Nursing, University of Toronto. Barbara Leighton is in the Department of Anesthesiology, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania and is the Visiting Professor of Obstetrical Anesthesia, Center for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada.
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Address correspondence to Dr. Stephen Halpern, Department of Anesthesia, Women's College Hospital, 76 Grenville Street, Toronto, Ontario, M5S 1B2, Canada.© 1999 Blackwell Science, Inc.

Abstract

Background: The effect of labor analgesia on breastfeeding success is not well defined. Some authors have hypothesized that labor analgesia may affect lactation success. The purpose of this observational study was to determine if intrapartum analgesia influenced breastfeeding success at 6 weeks postpartum in a setting that strongly supported breastfeeding. Methods: Healthy women with uncomplicated term pregnancies who planned to breastfeed consented to a telephone interview. We recorded demographic data, labor induction status, delivery mode, and analgesic medications. At between 6 and 8 weeks postpartum, patients were asked to describe breastfeeding use, problems encountered, solutions derived, sources of support and information, and satisfaction. We created a logistic regression model using intrapartum analgesia information and controlling for demographic factors previously correlated with lactation success. Results: We enrolled 189 women, contacted 177 women postpartum, and obtained complete data on 171 women. Of these, 59 percent received epidural analgesia, 72 percent breastfed fully, and 20 percent breastfed partially (> 50% of infant nutrition) at 6 weeks postpartum. After controlling for demographics and labor outcome, we could not demonstrate a correlation between breastfeeding success at 6 to 8 weeks and labor analgesia. Conclusions: In a hospital that strongly promotes breastfeeding, epidural labor analgesia with local anesthetics and opioids does not impede breastfeeding success. We recommend that hospitals that find decreased lactation success in parturients receiving epidural analgesia reexamine their postdelivery care policies.

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