Maternal Analgesia During Labor Disturbs Newborn Behavior: Effects on Breastfeeding, Temperature, and Crying

Authors

  • Anna-Berit Ransjö-Arvidson RNMTD, PhD,

    1. Anna-Berit Ransjö-Arvidson is Senior Lecturer and International Coordinator in the Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, and researcher at the Division of International Health, Karolinska Institutet, Stockholm; Ann-Sofi Matthiesen is Statistician and Lecturer in the Department of Statistics, Stockholm University, Stockholm; Gunilla Lilja is Lecturer, Eva Nissen is Senior Lecturer, and Ann-Marie Widström is Assistant Professor at the Division of Reproductive and Perinatal Health Care in the Department of Women and Child Health, Karolinska Institutet, Stockholm; and Kerstin Uvnäs-Moberg is Professor in the Department of Pharmacology, Karolinska Institutet, Stockholm, and the Department of Animal Physiology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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  • Ann-Sofi Matthiesen BSc,

    1. Anna-Berit Ransjö-Arvidson is Senior Lecturer and International Coordinator in the Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, and researcher at the Division of International Health, Karolinska Institutet, Stockholm; Ann-Sofi Matthiesen is Statistician and Lecturer in the Department of Statistics, Stockholm University, Stockholm; Gunilla Lilja is Lecturer, Eva Nissen is Senior Lecturer, and Ann-Marie Widström is Assistant Professor at the Division of Reproductive and Perinatal Health Care in the Department of Women and Child Health, Karolinska Institutet, Stockholm; and Kerstin Uvnäs-Moberg is Professor in the Department of Pharmacology, Karolinska Institutet, Stockholm, and the Department of Animal Physiology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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  • Gunilla Lilja RNMTD,

    1. Anna-Berit Ransjö-Arvidson is Senior Lecturer and International Coordinator in the Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, and researcher at the Division of International Health, Karolinska Institutet, Stockholm; Ann-Sofi Matthiesen is Statistician and Lecturer in the Department of Statistics, Stockholm University, Stockholm; Gunilla Lilja is Lecturer, Eva Nissen is Senior Lecturer, and Ann-Marie Widström is Assistant Professor at the Division of Reproductive and Perinatal Health Care in the Department of Women and Child Health, Karolinska Institutet, Stockholm; and Kerstin Uvnäs-Moberg is Professor in the Department of Pharmacology, Karolinska Institutet, Stockholm, and the Department of Animal Physiology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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  • Eva Nissen RNMTD, PhD,

    1. Anna-Berit Ransjö-Arvidson is Senior Lecturer and International Coordinator in the Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, and researcher at the Division of International Health, Karolinska Institutet, Stockholm; Ann-Sofi Matthiesen is Statistician and Lecturer in the Department of Statistics, Stockholm University, Stockholm; Gunilla Lilja is Lecturer, Eva Nissen is Senior Lecturer, and Ann-Marie Widström is Assistant Professor at the Division of Reproductive and Perinatal Health Care in the Department of Women and Child Health, Karolinska Institutet, Stockholm; and Kerstin Uvnäs-Moberg is Professor in the Department of Pharmacology, Karolinska Institutet, Stockholm, and the Department of Animal Physiology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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  • Ann-Marie Widström RNMTD, PhD,

    1. Anna-Berit Ransjö-Arvidson is Senior Lecturer and International Coordinator in the Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, and researcher at the Division of International Health, Karolinska Institutet, Stockholm; Ann-Sofi Matthiesen is Statistician and Lecturer in the Department of Statistics, Stockholm University, Stockholm; Gunilla Lilja is Lecturer, Eva Nissen is Senior Lecturer, and Ann-Marie Widström is Assistant Professor at the Division of Reproductive and Perinatal Health Care in the Department of Women and Child Health, Karolinska Institutet, Stockholm; and Kerstin Uvnäs-Moberg is Professor in the Department of Pharmacology, Karolinska Institutet, Stockholm, and the Department of Animal Physiology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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  • Kerstin Uvnäs-Moberg MD, PhD

    1. Anna-Berit Ransjö-Arvidson is Senior Lecturer and International Coordinator in the Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, and researcher at the Division of International Health, Karolinska Institutet, Stockholm; Ann-Sofi Matthiesen is Statistician and Lecturer in the Department of Statistics, Stockholm University, Stockholm; Gunilla Lilja is Lecturer, Eva Nissen is Senior Lecturer, and Ann-Marie Widström is Assistant Professor at the Division of Reproductive and Perinatal Health Care in the Department of Women and Child Health, Karolinska Institutet, Stockholm; and Kerstin Uvnäs-Moberg is Professor in the Department of Pharmacology, Karolinska Institutet, Stockholm, and the Department of Animal Physiology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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Address correspondence to Anna-Berit Ransjö-Arvidson, IHCAR, Karolinska Institutet, S-171 76 Stockholm, Sweden.

Abstract

Background:Newborns not exposed to analgesia, when placed on the mother's chest, exhibit an inborn prefeeding behavior. This study was performed to assess the effects of different types of analgesia during labor on the development of spontaneous breastfeeding movements, crying behavior, and skin temperature during the first hours of life in healthy term newborns.Methods:Video recordings were made of 28 newborns who had been dried and placed in skin-to-skin contact between their mother's breasts immediately after delivery. The video recordings were analyzed blindly with respect to infant exposure to analgesia. Defined infant behaviors were assessed every 30 seconds. Group 1 mothers (n = 10) had received no analgesia during labor, group 2 mothers (n= 6) had received mepivacaine via pudendal block, and group 3 mothers (n= 12) had received pethidine or bupivacaine or more than one type of analgesia during labor.Results:All infants made finger and hand movements, but the infant's massagelike hand movements were less frequent in infants whose mothers had received labor analgesia. A significantly lower proportion of group 3 infants made hand-to-mouth movements (p < 0.001), and a significantly lower proportion of the infants in groups 2 and 3 touched the nipple with their hands before suckling (p < 0.01), made licking movements (p < 0.01), and sucked the breast (p < 0.01). Nearly one-half of the infants, all in groups 2 or 3, did not breastfeed within the first 2.5 hour of life. The infants whose mothers had received analgesia during labor had higher temperatures (p= 0.03) and they cried more (p= 0.05) than infants whose mothers had not received any analgesia.Conclusions:The present data indicate that several types of analgesia given to the mother during labor may interfere with the newborn's spontaneous breast-seeking and breastfeeding behaviors and increase the newborn's temperature and crying.

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