title: Effects of different anesthesia protocols on lactation in the postpartum period.
abstract: OBJECTIVE
  Many factors can influence the secretion of breast milk. Cesarean section is a risk factor for late onset of breastfeeding.
  
  
  METHODS
  In our study, we compared the lactation process by mothers who underwent elective cesarean section under general anesthesia, spinal anesthesia, epidural anesthesia, and normal birth; 84 patients between 18-40 years of age with a risk of ASA I-II were included. Randomly patients were divided into four groups: group G (general anesthesia, n:21), group S (spinal anesthesia, n:21), group E (epidural anesthesia, n:21), and group V (vaginal birth, without anesthesia, n:21). Oxytocin and prolactin values of all patients before and after operation or birth were recorded. In addition the initiation time of lactation after delivery or cesarean section were recorded.
  
  
  RESULTS
  In all groups, there were no significant differences among hormone levels in the prepartum period (p=0.350). Prolactin levels in group G (p=0.011) and oxytocin levels in group V (p=0.012) in the postpartum period were significantly higher than in the other groups. The start of lactation was significantly delayed in group G (p=0.003).
  
  
  CONCLUSIONS
  We consider that the onset time of lactation is delayed in patients undergoing cesarean section with general anesthesia when compared with patients who undergo cesarean section with spinal and epidural anesthesia and with patients who undergo normal vaginal birth. Because of the delay of awakening and recovery of cognitive functions in general anesthesia, communication between the mother and the newborn is delayed and so is the lactation.
authors.affiliation: Department of Anesthesiology, Düzce University Faculty of Medicine, Düzce, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Kutlucan
authors.affiliation: Department of Anesthesiology, Düzce University Faculty of Medicine, Düzce, Turkey.
authors.forename: İlknur S
authors.initials: İS
authors.lastname: Seker
authors.affiliation: Department of Anesthesiology, Düzce University Faculty of Medicine, Düzce, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Demiraran
authors.affiliation: Department of Anesthesiology, Düzce University Faculty of Medicine, Düzce, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Ersoy
authors.affiliation: Department of Anesthesiology, Düzce University Faculty of Medicine, Düzce, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Karagöz
authors.affiliation: Department of Anesthesiology, Düzce University Faculty of Medicine, Düzce, Turkey.
authors.forename: Gülbin
authors.initials: G
authors.lastname: Sezen
authors.affiliation: Department of Obstetrics and Gynecology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
authors.forename: Seyit Ali
authors.initials: SA
authors.lastname: Köse
keywords: Anesthesia technique; lactation; normal birth