Epidural analgesia: Breast-feeding success and related factors

Wiklund, Ingela; Norman, M; Uvnäs‐Moberg, Kerstin; Ransjö‐Arvidson, Anna‐Berit; Andolf, Ellika

doi:10.1016/j.midw.2007.07.005

Cited by 81 publications

(89 citation statements)

References 24 publications

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“…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). These newborns needed synthetic nutrients, and in addition, a lower proportion of them was breastfeeding only when discharged.…”

Section: Discussionmentioning

confidence: 96%

Effects of different anesthesia protocols on lactation in the postpartum period

Kutlucan¹,

Şeker²,

Demiraran³

et al. 2014

J Turkish German Gynecol Assoc

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Section: Discussionmentioning

confidence: 96%

Effects of different anesthesia protocols on lactation in the postpartum period

Kutlucan¹,

Şeker²,

Demiraran³

et al. 2014

J Turkish German Gynecol Assoc

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“…This is difficult to explain, but associations between epidural anesthesia and altered breastfeeding initiation are well documented [7,37] . Women prepared to deliver without anesthesia may be expected to breastfeed without recourse to feeding aids.…”

Section: Discussionmentioning

confidence: 99%

“…The main risk factors for shorter or non-initiated breastfeeding are maternal obesity [2] , high gestational weight gain (GWG) [16] , low social status [12] , epidural anesthesia during labor [37] , cesarean section [32] , and delayed skin-to-skin contact [24] .…”

Section: Introductionmentioning

confidence: 99%

Determinants of successful breastfeeding initiation in healthy term singletons: a Swiss university hospital observational study

Gubler

Krähenmann

Roos

et al. 2012

Journal of Perinatal Medicine

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Aims: Breastfeeding significantly benefits mothers and infants. We aimed to identify the determinants of its successful initiation. Methods: A retrospective study of 1893 mothers delivering healthy term singletons at a Swiss university hospital from 1/2008 to 3/2009 determined the associations between multiple breastfeeding and early postpartum parameters by univariate and multiple regression analysis. Results: Multiparity was associated with nursing exclusively at the breast at discharge (P < 0.001), less use of maltodextrin supplement (P < 0.05), bottle/cup (both P < 0.001), but more pacifier use (P < 0.05). Among obese mothers, nursing exclusively at the breast at discharge was less frequent, and use of all feeding aids more frequent, than among normal-weight women (both P < 0.001). Neuraxial anesthesia was associated with use of maltodextrin and bottle (both P < 0.05) compared to no anesthesia. Delayed first skin-to-skin contact and rooming-in for < 24 h/day were each associated with maltodextrin and cup (P < 0.05). Nursing exclusively at the breast at discharge was less frequent (P < 0.001), and bottle use more frequent (P < 0.05), in women with sore nipples than in those without. Conclusions: Obesity is a potent inhibitor of breastfeeding initiation. Delivery without anesthesia by a multi parous normal-weight mother, followed by immediate skin-toskin contact, rooming-in for 24 h/day, and dedicated nipple care, provides the best conditions for successful early postpartum breastfeeding without the need for feeding aids or nutritional supplements.

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“…There was no information given in any of the classes about epidural analgesia increasing the risk of instrumental birth (Anim-Somuah et al, 2011) or decreasing breastfeeding rates (Kendall-Tackett et al, 2015;Jordan et al, 2009;Wiklund et al, 2009) and all midwives stated that there were no known effects on the newborn. While all of the midwives attempted to describe the pain of labour in encouraging terms, such as being 'positive' or 'good' or urging the women to 'trust their bodies', the rules of the institution were constantly being referred to: 'we don't like you to eat', 'you can only bring two support people', 'we expect you to progress one centimetre an hour', 'there is a time we will need you to have your baby by'.…”

Section: Resultsmentioning

confidence: 99%

‘It's your body, but…’ Mixed messages in childbirth education: Findings from a hospital ethnography

2017

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Objective: to investigate the personal, social, cultural and institutional influences on women making decisions about using epidural analgesia in labour. In this article we discuss the findings that describe practices around the gaining of consent for an epidural in labour, which we juxtapose with similar processes relating to use of water for labour and/or birth.Design: ethnography.Setting: tertiary hospital in Australian city. Participants: sequential interviews were conducted with 16 women; hospital staff (primarily midwives and doctors) participated during six months of participatory observation fieldwork.Findings: women were not given full disclosure of either practice and midwives tailored the information they gave according to the institutional policies rather than evidence.Key conclusions: informed consent is an oft-cited human right in health care, yet in maternity care the micropolitics of how informed consent is gained is difficult to ascertain, leading to a situation whereby the concept of informed consent is more robust than the reality of practice; an illusion of informed consent exists, yet information is often biased towards medicalised birth practices.Implications for practice: as primary maternity care-givers, midwives have a role in providing unbiased information to women; however it appears that hospital culture and policy affect the way that this information is presented. It is arguable whether women in such instances are giving true informed consent, and for this reason, the ethics of these hidden practices are questioned.

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Epidural analgesia: Breast-feeding success and related factors

Cited by 81 publications

References 24 publications

Effects of different anesthesia protocols on lactation in the postpartum period

Effects of different anesthesia protocols on lactation in the postpartum period

Determinants of successful breastfeeding initiation in healthy term singletons: a Swiss university hospital observational study

‘It's your body, but…’ Mixed messages in childbirth education: Findings from a hospital ethnography

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