title: Effect of labor analgesia on breastfeeding success.
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.
authors.affiliation: Department of Anesthesia, University of Toronto, Women's College Hospital, Ontario, Canada.
authors.forename: S H
authors.initials: SH
authors.lastname: Halpern
authors.forename: T
authors.initials: T
authors.lastname: Levine
authors.forename: D B
authors.initials: DB
authors.lastname: Wilson
authors.forename: J
authors.initials: J
authors.lastname: MacDonell
authors.forename: S E
authors.initials: SE
authors.lastname: Katsiris
authors.forename: B L
authors.initials: BL
authors.lastname: Leighton
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D001294:Attitude to Health; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D007744:Obstetric Labor Complications / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors