Document Detail


Effect of labor epidural anesthesia on breast-feeding of healthy full-term newborns delivered vaginally.
MedLine Citation:
PMID:  12583645     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epidural anesthesia is commonly administered to laboring women. Some studies have suggested that epidural anesthesia might inhibit breast-feeding. This study explores the association between labor epidural anesthesia and early breast-feeding success. METHODS: Standardized records of mother-baby dyads representing 115 consecutive healthy, full-term, breast-feeding newborns delivered vaginally of mothers receiving epidural anesthesia were analyzed and compared with 116 newborns not exposed to maternal epidural anesthesia. Primary outcome was two successful breast-feeding encounters by 24 hours of age, as defined by a LATCH breast-feeding assessment score of 7 or more of 10 and a latch score of 2/2. Means were compared with the Kruskal-Wallis test. Categorical data were compared using the Mantel-Haenszel chi-square test. Stratified analysis of potentially confounding variables was performed using Mantel-Haenszel weighted odd ratios (OR) and chi-square for evaluation of interaction. RESULTS: Both epidural and nonepidural anesthesia groups were similar except maternal nulliparity was more common in the epidural anesthesia group. Two successful breast-feedings within 24 hours of age were achieved by 69.6% of mother-baby units that had had epidural anesthesia compared with 81.0% of mother-baby units that had not (odds ratio [OR] 0.53, P = .04). These relations remained after stratification (weighted odds ratios in parenthesis) based on maternal age (0.52), parity (0.58), narcotics use in labor (0.49), and first breast-feeding within 1 hour (0.49). Babies of mothers who had had epidural anesthesia were significantly more likely to receive a bottle supplement while hospitalized (OR 2.63; P < .001) despite mothers exposed to epidural anesthesia showing a trend toward being more likely to attempt breast-feeding in the 1 hour (OR 1.66; P = .06). Mothers who had epidural anesthesia and who did not breast-feed within 1 hour were at high risk for having their babies receive bottle supplementation (OR 6.27). CONCLUSIONS: Labor epidural anesthesia had a negative impact on breast-feeding in the first 24 hours of life even though it did not inhibit the percentage of breast-feeding attempts in the first hour. Further studies are needed to elucidate the exact nature of this association.
Authors:
Dennis J Baumgarder; Patricia Muehl; Mary Fischer; Bridget Pribbenow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of the American Board of Family Practice / American Board of Family Practice     Volume:  16     ISSN:  0893-8652     ISO Abbreviation:  J Am Board Fam Pract     Publication Date:    2003 Jan-Feb
Date Detail:
Created Date:  2003-02-13     Completed Date:  2003-05-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8807505     Medline TA:  J Am Board Fam Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  7-13     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, University of Wisconsin Medical School, Milwaukee Clinical Campus, St. Luke's Medical Center, Aurora Health Care, Milwaukee, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Epidural*
Anesthesia, Obstetrical*
Bottle Feeding / statistics & numerical data
Breast Feeding / statistics & numerical data*
Female
Humans
Infant, Newborn
Maternal Age
Parity
Pregnancy
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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