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


METHODS
Retrospective cohort.


METHODS
Maternity unit of a UK district general hospital.


METHODS
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.


METHODS
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 mug).


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.
Jordan
Sue
S
School of Health Science, University of Wales, Swansea, UK.
Emery
Simon
S
Bradshaw
Ceri
C
Watkins
Alan
A
Friswell
Wendy
W
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000932:Antiemetics / Q000627:therapeutic use; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D010146:Pain / Q000517:prevention & control*; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D000932:Antiemetics; D005283:Fentanyl