title: The impact of breastfeeding on postpartum pain after vaginal and cesarean delivery.
abstract: OBJECTIVE
  Oxytocin may play a role in pain modulation. The analgesic effects of breastfeeding with its associated endogenous oxytocin release have not been well investigated. To determine the impact of breastfeeding on incisional, perineal, and cramping pain after cesarean and vaginal delivery.
  
  
  METHODS
  Institutional review board-approved prospective observational study.
  
  
  METHODS
  Labor and delivery and maternity wards.
  
  
  METHODS
  Healthy (American Society of Anesthesiology physical statuses 1 and 2) multiparous women who had cesarean (n = 40) and vaginal (n = 43) deliveries of singleton term infants and who were breastfeeding were enrolled.
  
  
  METHODS
  Women completed diaries to record incisional, perineal, or cramping pain scores 5 minutes before, during, and 5 minutes after breastfeeding.
  
  
  METHODS
  Demographic, obstetric, and neonatal variables, as well as analgesic use, were recorded.
  
  
  RESULTS
  There was no difference in incisional pain before, during, and after breastfeeding in women post-cesarean delivery. Cramping pain was significantly increased during, as compared with before or after breastfeeding in both the vaginal (P < .001) and cesarean (P < .001) delivery cohorts.
  
  
  CONCLUSIONS
  There was no analgesic effect on incisional pain during breastfeeding, indicating that endogenous oxytocin associated with breastfeeding may not play a significant role in postpartum cesarean wound pain modulation. Breastfeeding increased cramping pain after vaginal and cesarean delivery. The increase in cramping pain is most likely due to the breastfeeding-associated oxytocin surge increasing uterine tone.
authors.affiliation: Department of Anesthesia, Stanford University School of Medicine, Rm H3580, 300 Pasteur Dr, Stanford, CA 94305, USA.
authors.forename: Louise
authors.initials: L
authors.lastname: Wen
authors.affiliation: Department of Anesthesia, Stanford University School of Medicine, Rm H3580, 300 Pasteur Dr, Stanford, CA 94305, USA. Electronic address: ghilton@stanford.edu.
authors.forename: Gillian
authors.initials: G
authors.lastname: Hilton
authors.affiliation: Department of Anesthesia, Stanford University School of Medicine, Rm H3580, 300 Pasteur Dr, Stanford, CA 94305, USA.
authors.forename: Brendan
authors.initials: B
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D001942:Breast Feeding; D002585:Cesarean Section / Q000379:methods; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D010121:Oxytocin / Q000378:metabolism*; D010146:Pain / Q000453:epidemiology*; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D010121:Oxytocin
keywords: Analgesia; Breastfeeding; Cesarean; Oxytocin; Vaginal delivery