title: Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding.
abstract: This prospective cohort study examined the association between epidural analgesia during labor and delivery, infant neurobehavioral status, and the initiation and continuation of effective breastfeeding. Healthy, term infants delivered vaginally by mothers who received epidural analgesia (n = 52) or no analgesia (n = 63) during labor and delivery were assessed at 8 to 12 hours postpartum, followed by a telephone interview with the mothers at 4 weeks postpartum. There was no significant difference between the epidural analgesia and no-analgesia groups in breastfeeding effectiveness or infant neurobehavioral status at 8 to 12 hours or in the proportion of mothers continuing to breastfeed at 4 weeks. Therefore, epidural analgesia did not appear to inhibit effective breastfeeding. There was a positive correlation between infant neurobehavioral status and breastfeeding effectiveness (Spearman rho = 0.48, P = .01), suggesting that neurobehavioral assessment may prove beneficial in identifying infants at greater risk for breastfeeding difficulties.
authors.affiliation: Labor, Delivery, Recovery, Postpartum Unit, Women's Hospital, Health Sciences Centre, Winnipeg, Manitoba, Canada.
authors.forename: Zorina Marzan
authors.initials: ZM
authors.lastname: Chang
authors.forename: Maureen I
authors.initials: MI
authors.lastname: Heaman
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D001942:Breast Feeding / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000187:drug effects; D007231:Infant, Newborn / Q000502:physiology*; D007774:Lactation / Q000187:drug effects / Q000502:physiology*; D007744:Obstetric Labor Complications; D010146:Pain / Q000188:drug therapy; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors