breastfeed than those who give birth naturally..."
By David King
December 11, 2006 12:00am
Women who give birth with the aid of pain-relieving epidurals find it harder to
breastfeed than those who give birth naturally, an Australian study has
The research suggests some of the drugs used in epidurals make
their way into babies' bloodstreams, subtly affecting their brains and
development for weeks afterwards - including making them less willing to
The study by University of Sydney epidemiologist Siranda
Torvaldsen adds to a growing body of knowledge that makes a link between the use
of the pain-killing drug fentanyl in epidurals and problems with
During an epidural a catheter is inserted into the spine
to allow the infusion of pain-killing drugs. These deaden the nerves that relay
sensations of pain from the lower body.
In a commentary on the research,
published today in International Breastfeeding Journal, British scientist Sue
Jordan suggests the impact of epidurals on breastfeeding should be officially
classed as an "adverse drug reaction".
Dr Jordan, senior lecturer in
applied therapeutics at Swansea University, said women given the infusions
should be offered extra support to stop their infants being "disadvantaged by
this hidden, but far-reaching, adverse drug reaction".
Dr Torvaldsen and
her colleagues studied 1280 women who had given birth in the ACT, of whom 416
had an epidural. They found that 93 per cent of the women breastfed their baby
in the first week, but those who had received epidurals generally had more
difficulty in the days immediately after birth.
By the time six months
had passed, the women who had been given epidurals were twice as likely to have
stopped breast-feeding, even after allowing for factors such as maternal age and
The authors suggest the most likely cause of the problem was
fentanyl, an opioid widely used as one of the components of epidurals. Such
drugs pass quickly into the bloodstream and easily cross the placenta to reach
the unborn baby.
Dr Torvaldsen said she conducted the research after
speaking to lactation consultants who had noticed that since the addition of
fentanyl in epidurals they had seen more women having problems
She said her research added to other studies in the area,
particularly a Canadian study that examined fentanyl dosages and breastfeeding
outcomes. The Canadian study of 177 mothers found they were less likely to be
breastfeeding if they had been given an epidural with fentanyl.
Heads, a lactation consultant at Sydney's Royal Hospital for Women, said similar
problems had been seen when the pain-killer pethidine had been given to mothers
in late stages of labour.
She said some newborn babies had lost their
"sucking co-ordination" if the mother had an intra-muscular injection of the
pethidine in the last half hour of a normal delivery.
reporting: Sunday Times