title: Review article: Intrapartum neuraxial analgesia and breastfeeding outcomes: limitations of current knowledge.
abstract: Although numerous studies have addressed the relationship between intrapartum neuraxial analgesia, particularly epidural fentanyl, and breastfeeding, substantial study design limitations have precluded the current literature from furnishing strong, clinically significant conclusions. Lack of randomized controlled trials, nonstandardization of breastfeeding evaluations across studies, and failure to control for confounding variables all pose significant problems. Further research is needed to elucidate the specific relationship between neuraxial opioids and breastfeeding and, if there are significant associations, whether these drugs act directly on neonatal brain tissue to attenuate exhibition of breastfeeding behaviors. In this review, I will detail the deficiencies of the current literature and make recommendations for future research.
authors.affiliation: Case Western Reserve University School of Medicine, Department of Internal Medicine, University Hospitals Case Medical Center, Rm 3581 Lakeside, 11100 Euclid Avenue, Cleveland, OH 44106, USA. als124@case.edu
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Szabo
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000706:statistics & numerical data*; D000701:Analgesics, Opioid / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects; D015992:Body Mass Index; D001831:Body Temperature / Q000187:drug effects / Q000502:physiology; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D010120:Oxytocics / Q000009:adverse effects; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012944:Social Support; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D010120:Oxytocics