Presented in part at the Obstetric Anaesthetist’s Association annual scientific meeting, Jersey, Channel Islands, May 2009.
Epidural analgesia and breastfeeding: a randomised controlled trial of epidural techniques with and without fentanyl and a non-epidural comparison group
Article first published online: 12 NOV 2009
© 2009 The Authors. Journal compilation © 2009 The Association of Anaesthetists of Great Britain and Ireland
Volume 65, Issue 2, pages 145–153, February 2010
How to Cite
Wilson, M. J. A., MacArthur, C., Cooper, G. M., Bick, D., Moore, P. A. S., Shennan, A. and on behalf of the COMET Study Group UK (2010), Epidural analgesia and breastfeeding: a randomised controlled trial of epidural techniques with and without fentanyl and a non-epidural comparison group. Anaesthesia, 65: 145–153. doi: 10.1111/j.1365-2044.2009.06136.x
- Issue published online: 21 DEC 2009
- Article first published online: 12 NOV 2009
- Accepted: 20 September 2009
We compared breastfeeding initiation and duration in 1054 nulliaparae randomised to bupivacaine Control epidural, Combined Spinal Epidural or Low Dose Infusion and 351 matched non-epidural comparisons. Women were interviewed after delivery and completed a postal questionnaire at 12 months. Regression analysis determined factors which independently predicted breastfeeding initiation. Breastfeeding duration was subjected to Kaplan–Meier analysis. A similar proportion of women in each epidural group initiated breastfeeding. Women with no epidural did not report a higher initiation rate relative to epidural groups and those who received pethidine reported a lower initiation rate than control epidural (p = 0.002). Older age groups (p < 0.001) and non-white ethnicity (p < 0.026) were predictive of breastfeeding. Epidural fentanyl dose, delivery mode and trial group were not predictive. Mean duration for breastfeeding was similar across epidural groups (Control 13.3, Combined Spinal Epidural 15.5, Low Dose Infusion 15.0 weeks). Our data do not support an effect of epidural fentanyl on breastfeeding initiation.