title: The Association Between Common Labor Drugs and Suckling When Skin-to-Skin During the First Hour After Birth.
abstract: BACKGROUND
  Intrapartum drugs, including fentanyl administered via epidural and synthetic oxytocin, have been previously studied in relation to neonatal outcomes, especially breastfeeding, with conflicting results. We examined the normal neonatal behavior of suckling within the first hour after a vaginal birth while in skin-to-skin contact with mother in relation to these commonly used drugs. Suckling in the first hour after birth has been shown in other studies to increase desirable breastfeeding outcomes.
  
  
  METHODS
  Prospective comparative design. Sixty-three low-risk mothers self-selected to labor with intrapartum analgesia/anesthesia or not. Video recordings of infants during the first hour after birth while being held skin-to-skin with their mother were coded and analyzed to ascertain whether or not they achieved Stage 8 (suckling) of Widström's 9 Stages of newborn behavior during the first hour after birth.
  
  
  RESULTS
  A strong inverse correlation was found between the amount and duration of exposure to epidural fentanyl and the amount of synthetic oxytocin against the likelihood of achieving suckling during the first hour after a vaginal birth.
  
  
  CONCLUSIONS
  Results suggest that intrapartum exposure to the drugs fentanyl and synthetic oxytocin significantly decreased the likelihood of the baby suckling while skin-to-skin with its mother during the first hour after birth.
authors.affiliation: Healthy Children Project, Inc., East Sandwich, MA, USA.|Maternal Child Health, Union Institute and University, Cincinnati, OH, USA.
authors.forename: Kajsa
authors.identifier: http://orcid.org/0000-0003-3789-635X
authors.initials: K
authors.lastname: Brimdyr
authors.affiliation: Healthy Children Project, Inc., East Sandwich, MA, USA.|Maternal Child Health, Graduate Program in Health and Wellness, Union Institute and University, Cincinnati, OH, USA.
authors.forename: Karin
authors.initials: K
authors.lastname: Cadwell
authors.affiliation: Division of Reproductive Health, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Widström
authors.affiliation: Division of Reproductive Health, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kristin
authors.initials: K
authors.lastname: Svensson
authors.affiliation: Obstetric Anesthesiology, Loma Linda University School of Medicine, Loma Linda University Children's Hospital, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Neumann
authors.affiliation: Loma Linda University School of Medicine, Loma Linda University Children's Hospital, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Elaine A
authors.initials: EA
authors.lastname: Hart
authors.affiliation: Kern Medical Center, Bakersfield, CA, USA.|Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Harrington
authors.affiliation: Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda University Children's Hospital, Loma Linda University Medical Center, Loma Linda, CA, USA.
authors.forename: Raylene
authors.initials: R
authors.lastname: Phillips
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000009:adverse effects; D000767:Anesthesia, Epidural / Q000379:methods; D001942:Breast Feeding / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008431:Maternal-Fetal Exchange / Q000187:drug effects*; D009321:Natural Childbirth / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects; D010121:Oxytocin / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D013391:Sucking Behavior / Q000187:drug effects*; D013997:Time Factors
chemical_list: D000759:Adjuvants, Anesthesia; D010120:Oxytocics; D010121:Oxytocin; D005283:Fentanyl
keywords: epidural; fentanyl; skin-to-skin