New Study Links Epidurals and Lower Breastfeeding Rates

Epidurals given during childbirth labour are associated with decreased rates of breastfeeding, a study involving a University of Sydney researcher has found.

The large study of Australian women found women who had epidurals during childbirth were more likely to have breastfeeding problems in the first week compared with women who had no analgesia. They were also more likely to give up breastfeeding before six months.

Dr Siranda Torvaldsen, from the University of Sydney, and her colleagues studied 1280 women who had given birth in the Australian Capital Territory in 1997. Of these women 416 (33%) had an epidural during the birth of their baby, 172 (41%) of whom also had a caesarean section.

Dr Torvaldsen said although most (93%) women breastfed their baby in the first week, epidural anesthesia was significantly associated with difficulty breastfeeding in the few days after birth, and with partial breastfeeding in the first week after delivery.

The women who had epidurals were also twice as likely to completely stop breastfeeding before six months compared with women who used no analgesia (after controlling for maternal age and education).

Seventy-two percent of women who had no analgesia were breastfeeding at 24 weeks, compared with 53% who received pethidine or epidurals containing bupivacaine and fentanyl (an opioid).

The authors conclude that this study adds to the growing body of evidence that the fentanyl component of epidurals may be associated with difficulty establishing breastfeeding.

The article, titled Intrapartum epidural analgesia and breastfeeding: a prospective cohort study, is published today in the open access journalInternational Breastfeeding Journal.