Breast-feeding problems after epidural analgesia for labour: a retrospective cohort study of pain, obstetrical procedures and breast-feeding practices

Volmanen, Petri; Valanne, J; Alahuhta, Seppo

doi:10.1016/s0959-289x(03)00104-3

Cited by 54 publications

(51 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the same study, onset of lactation was significantly later in the general anesthesia group (9). In all three studies, the groups of epidural anesthesia and no anesthesia were compared, and it was determined that the onset time of lactation was the latest in the epidural group (10)(11)(12). Especially, the breastfeeding rate in the first 4 hours was determined to be lower in mothers who delivered with epidural anesthesia (13).…”

Section: Discussionmentioning

confidence: 99%

Effects of different anesthesia protocols on lactation in the postpartum period

Kutlucan¹,

Şeker²,

Demiraran³

et al. 2014

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Effects of different anesthesia protocols on lactation in the postpartum period

Kutlucan¹,

Şeker²,

Demiraran³

et al. 2014

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

“…Subsequent studies also suggest that the use of an epidural with low-dose concentrations of bupivacaine and fentanyl after the initiation of breastfeeding has no effect on the duration or success of continued breastfeeding (Volmanen et al, 2004). An area of particular concern to anesthesia providers relates to the assertion that anesthetic agents used to control pain after birth may have a negative impact on the mother's ability to successfully breastfeed.…”

Section: Use Of Anesthetic Agents To Control Pain Following Birthmentioning

confidence: 99%

“…Researchers have also found that other variables may be linked to initiation and continuation of breastfeeding, including older age of the mother (some studies note younger mothers), ethnic minority status, lack of family support systems, lower social economic status, and not having enough milk production (Dennis, 2002;Jordan, Emery, Bradshaw, Watkins, & Friswell, 2005;Volmanen, Valanne, & Alahuhta, 2004). Additional studies have concluded that working part time, as opposed to full time, is an effective strategy to promote continued breastfeeding (Fein & Roe, 1998).…”

mentioning

confidence: 99%

Breastfeeding Problems Following Anesthetic Administration

Howie

McMullen²

2006

jpe

View full text Add to dashboard Cite

Research literature supports the notion that maternal comfort should be considered a priority and that mothers should receive adequate information regarding any drug prior to receiving that drug. Some studies indicate that difficulties with breastfeeding may be related to the amount of the anesthetic or analgesic that is administered to the mother. Thus, it seems wise to administer the lowest possible dose to the mother in order to minimize the amount of drug (or metabolite) exposure to the nursing infant. Infant exposure can be further reduced if breastfeeding is avoided during the times when the mother receives high doses of anesthetics and analgesics. However, because relatively small amounts of the drug are excreted into the breast milk, some mothers may opt to continue nursing after weighing the benefits of breastfeeding against the potential risk to the infant. Others may choose to ''pump and dump'' breast milk while they receive anesthetic or analgesic agents. Any concerns in this regard should be discussed with the anesthesia provider, preferably prior to labor or to any surgeries while breastfeeding.

show abstract

“…In a cohort in the North of Finland, breast-feeding problems as well as mixed or full bottle feeding were more common among those receiving EDA (Volmanen et al 2004). Observational studies concerning EDA are, however, subject to selection bias.…”

Section: Effects Of Maternal Analgesia On the Neonatementioning

confidence: 97%

Intravenous patient-controlled analgesia with remifentanil in early labour

Volmanen¹

2011

Acta Anaesthesiologica Scandinavica

View full text Add to dashboard Cite

Cover design Raimo Ahonen JUVENES PRINT TAMPERE 2010Volmanen, Petri, Intravenous patient controlled analgesia with remifentanil in early labour. AbstractIn four prospective clinical trials, 114 parturients used intravenous patient-controlled remifentanil analgesia during the 1 st stage of labour. The median effective dose per bolus was ascertained to be 0.4 μg/kg and the pain scores were reduced with this by a median of 2 on a numerical scale (0-10). Compared with nitrous oxide, 15 parturients included in a cross-over study reported a larger reduction in pain scores during remifentanil analgesia (1.5 vs. 0.5, p = 0.001) and better pain relief scores (2.5 vs. 0.5 on a ranked five point scale 0-4, p < 0.001). In a parallel study including 45 parturients, epidural analgesia (EDA, 20 ml bupivacaine 0.625 mg/ml and fentanyl 2 μg/ml) was associated with lower pain scores (5.2 vs. 7.3 with remifentanil, p = 0.004) but variables related to satisfaction with analgesia (pain relief score, proportion of mothers with desire to continue with the given medication and termination of the study due to inadequate pain relief) were similar. A comparison of two methods for timing the remifentanil bolus during the uterine contraction cycle suggested that delaying the bolus does not improve analgesia. A period effect was noted in the cross-over trial with higher pain scores and increased drug consumption during the second study period suggesting acute hyperalgesia.Side effects of remifentanil analgesia included respiratory depression warranting oxygen supplementation in 33% of parturients. Sedation was experienced by the parturients using remifentanil and this was scored as stronger than sedation during nitrous oxide and EDA. The number of parturients with nausea did not increase during remifentanil analgesia. Other maternal side effects included dizziness, a difficulty in visual focusing and itching. Foetal heart rate tracing abnormalities were noted. The incidence of abnormal tracings and decreased UapH were not different, however, from that observed during nitrous oxide or EDA. Apgar scores at 1 and 5 minute indicated no neonatal depression. Keywords

show abstract

Breast-feeding problems after epidural analgesia for labour: a retrospective cohort study of pain, obstetrical procedures and breast-feeding practices

Cited by 54 publications

References 11 publications

Effects of different anesthesia protocols on lactation in the postpartum period

Effects of different anesthesia protocols on lactation in the postpartum period

Breastfeeding Problems Following Anesthetic Administration

Intravenous patient-controlled analgesia with remifentanil in early labour

Contact Info

Product

Resources

About