Maternal analgesia during labor disturbs newborn behavior: effects on breastfeeding, temperature, and crying.
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.
Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden.
A B
AB
Ransjö-Arvidson
A S
AS
Matthiesen
G
G
Lilja
E
E
Nissen
A M
AM
Widström
K
K
Uvnäs-Moberg
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000701:Analgesics, Opioid / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects; D001942:Breast Feeding; D002045:Bupivacaine / Q000009:adverse effects; D003448:Crying; D005247:Feeding Behavior / Q000187:drug effects*; D005260:Female; D006801:Humans; D018730:Infant Behavior / Q000187:drug effects*; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000187:drug effects; D008614:Meperidine / Q000009:adverse effects; D008619:Mepivacaine / Q000009:adverse effects; D011247:Pregnancy; D012881:Skin Temperature / Q000187:drug effects; D013997:Time Factors; D014741:Video Recording
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008614:Meperidine; D008619:Mepivacaine; D002045:Bupivacaine