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1999 LLLI Conference Sessions:
Medication during Birth and Breastfeeding

By Paulette Woodard
From: NEW BEGINNINGS, Vol. 16 No. 5, September-October 1999, p. 167

Jan Riordan, RN, MSN, EdD, IBCLC, and La Leche League Leader, started her session by stating something that has become obvious to many lactation consultants, hospital staff workers, and La Leche League Leaders. These days, babies seem to be having more trouble with early suckling, latching on to the breast, disorganized suckling, and sleepiness in the first days of life. She then discussed what the research says about the connection between breastfeeding and epidurals.

Dr. Riordan gave a brief history of pain relief during childbirth. Unmedicated birth resulted in babies who generally suckled early and well. With the beginning of medicated births where mothers were unconscious or had no memory of the birth, problems with breastfeeding and other postpartum difficulties became common. These were severe enough that unmedicated childbirth became more popular by the early 80s. As epidurals became common, natural childbirth lost ground. We watched a hospital video in which epidural anesthesia was depicted as a pain-free, mostly risk-free way of managing labor and birth that would not affect the baby. Riordan noted that side effects and problems with epidurals are often minimized in materials used to educate expectant mothers.

Riordan's presentation looked at several studies showing the effects of medicated births on mother and baby. The effects included a drop in some mothers' blood pressure, head or backaches after delivery, prolonged second stage of labor, increased rate of cesareans births, more instrument-assisted deliveries, and more common fetal distress. Mothers also develop fevers after birth that may be mistaken for infection and lead to separation of mother and baby.

Most of the research didn't study problems with breastfeeding associated with epidurals, so Riordan developed a study to focus on epidural anesthesia 's effect on the baby's suckling and the duration of breastfeeding. She explained the methodology of her study and its results. It clearly showed that medication during birth did negatively affect babies' suckling during the first 12 hours, and that combining medications increased the effect. Demerol was especially harmful to the baby's suckling ability. The duration of breastfeeding was not shown to be affected.

Riordan concluded that health care providers and childbirth educators should inform expectant mothers that diminished suckling is a risk of using pain medications during childbirth. Currently, these risks are frequently glossed over.

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