Dare I say it? Birthing naturally gives you a head start on the breastfeeding relationship.
There, I said it.
Feels good to get it out of my system.
Are there home birthing moms who never are able to successfully breastfeed? Of course. Are there moms who have had c-sections who have nursed with ease? Yes again.
But let’s be real, an overly medicalized birth can most certainly throw a wrench into the natural process of breastfeeding your baby. Here are eight ways that breastfeeding can be disturbed by birth interventions and drugs.
1) Pitocin can increase jaundice in the newborn
Pitocin must be one of the most used drugs in obstetrics. Surly it has it’s place and has saved many a life for postpartum hemorrhage. But lets talk about JAUNDICE and the role of Pitocin in it. The package insert for Pitocin notes that:
The following adverse reactions have been reported in the fetus or neonate:
Due to induced uterine motility:
- Premature ventricular contractions and other arrhythmias
- Permanent CNS or brain damage
- Fetal death
- Neonatal seizures have been reported with the use of Pitocin
- Low Apgar scores at five minutes
- Neonatal jaundice
- Neonatal retinal hemorrhage
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.
Obviously there are a few potential side effects, but I want to focus on jaundice. The National Library of Medicine points out that jaundice can cause excessive sleepiness in the newborn and “poor feeding”, among other things.
Any mother who has had a jaundiced baby knows that it is HARD to nurse a baby that is lethargic. An overly tired and jaundiced baby kind of interrupts the whole natural “fussy, hungry baby needs food” thing that babies usually use to tell mama, “Hey – feed me!”
Instead, the baby just sleeps. And sleeps. And sleeps.
Then mama has to wake baby and struggle to keep him or her awake during feedings. Then baby needs to sleep on a special light blanket rather than near his food source. Then mama has a hard time making enough milk.
And thus we begin a difficult breastfeeding relationship because of a very common DRUG given to mothers.
2) Pethidine (also known as Demerol) in labor can decrease infant ability to suck
This study found that infants with higher concentrations of this drug in their system were less likely to suck after birth.
This Swedish study found that rooting and sucking behaviors in the newborn were depressed in mothers who had been given Pethidine in labor.
This study also found that Pethidine should be restricted in labor due to the negative impact it had on breastfeeding.
3) Stupid newborn procedures (immediate washing, separation, shots, etc) that take baby away from the mother have been shown to have a negative impact on breastfeeding
This Medscape article points out how important immediate skin-to-skin contact between mother and baby is for the breastfeeding relationship.
Keeping your baby close to you, delaying (or totally avoiding) needless separation and washing is one way that you can help ensure a longer and easier breastfeeding relationship. Find out your hospital’s policies on this. If you have a c-section, is separation mandatory? What about if you are medicated? You need to know, because there is a good chance it can impact your nursing relationship.
4) Epidurals can negatively impact breastfeeding initiation
This study found that women who delivered vaginally but received an epidural were significantly more likely to have their babies given a bottle while in the hospital, despite breastfeeding attempts.
5) Women who received drugs in labor are much less likely to be nursing at 24 weeks postpartum
This cohort study found that medications in labor had a large impact on both initial success and continuation of breastfeeding.
Women in this cohort who had epidurals were less likely to fully breastfeed their infant in the few days after birth and more likely to stop breastfeeding in the first 24 weeks. Although this relationship may not be causal, it is important that women at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support.
How many women who plan on breastfeeding actually know this before they get that epidural?
6) C-section is a barrier to breastfeeding
This study found that mode of delivery did impact breastfeeding, c-section mothers having more difficulty than vaginally delivering mothers.
Conclusions: The findings confirmed that cesarean section was a significant barrier to the implementation of Baby Friendly Hospital Initiative Step 4 and that hospital practices were amenable to changes that enabled its implementation regardless of the mode of delivery.
Step Four of the Baby Friendly Hospital Initiative is:
Help mothers initiate breastfeeding within one hour of birth.
While inhalation analgesia is rapidly eliminated from both mother and neonate, other analgesics cross the placenta and enter colostrum. Therefore, intrapartum analgesics may exert subtle effects on both infant and mother, hindering initiation of breastfeeding.
7) Fentanyl may impede breastfeeding
This study found that intrapartum fentanyl seemed to “thwart” breastfeeding.
8) C-section can delay the onset of milk production
Moms know that it takes milk supply a few days to begin. Until your milk “comes in” your baby can thrive with colostrum. What few women know is that c-sections can make this waiting period between birth and milk supply take longer.
This study found just that:
Prospective observational studies indicate that both maternal and fetal stress during labor and delivery (e.g., urgent Cesarean sections or long duration of labor in vaginal deliveries) are associated with delayed onset of lactation.
If you have a strong desire to breastfeed your baby, you may want to further research the impact of common drugs and procedures on your ability to do so. You might just want a more natural birth.
Blessings on your breastfeeding journey no matter how your birth goes!
Photo credit: Aurimas Mikalauskas (Share and share alike!)