The impact of intrapartum analgesia on infant feeding


Dr S. Jordan, School of Health Sciences, University of Wales, Swansea, Singleton Park, Swansea SA2 8PP, UK.


Objective  To investigate the impact of intrapartum analgesia on infant feeding at hospital discharge.

Design  Retrospective cohort.

Setting  Maternity unit of a UK district general hospital.

Population  A random sample of 425 healthy primiparae delivering healthy singleton babies at term in 2000.

Methods  A random sample of primiparae delivering term neonates was identified from the birth register. We retrieved and analysed the corresponding joint midwifery/obstetric case notes.

Main outcome measure  Infant feeding method at discharge from hospital.

Results  Women [190/424 (45%)] were exclusively bottle feeding their babies at discharge from hospital. No one commenced breastfeeding after hospital discharge. Regression analysis revealed that the main determinants of bottle feeding were as follows: maternal age [odds ratio (OR) 0.90, 95% confidence interval [CI] 0.85–0.95 per year]; occupation (OR 0.63, 95% CI 0.40–0.99 for each category, unemployed, manual, non-manual); antenatal feeding intentions (OR 0.12, 95% CI 0.080–0.19 for each category, bottle feeding, undecided, breastfeeding); caesarean section (OR 0.25, 95% CI 0.13–0.47, caesarean or vaginal delivery); and dose of fentanyl administered intrapartum (OR 1.004, 95% CI 1.000–1.008, 90% CI 1.001–1.007 for each microgram administered, range 8–500 μg).

Conclusions  A dose–response relationship between fentanyl and artificial feeding has not been reported elsewhere. When well-established determinants of infant feeding are accounted for, intrapartum fentanyl may impede establishment of breastfeeding, particularly at higher doses.