Epidural Babies Can't Get a Grip on What's "Breast"

[annettemarie]

Cross posted to Lactivism and I'm Pregnant

http://www.theaustralian.news.com.au...-23289,00.html

WOMEN who give birth with the aid of pain-relieving epidurals find it harder to breastfeed than those who give birth naturally, an Australian study has found.

The research suggests some of the drugs used in epidurals make their way into babies' bloodstreams, subtly affecting their brains and development for weeks afterwards -- including making them less willing to breastfeed. The study by University of Sydney epidemiologist Siranda Torvaldsen adds to a growing body of knowledge that makes a link between the use of the pain-killing drug fentanyl in epidurals and problems with breastfeeding. During an epidural a catheter is inserted into the spine to allow the infusion of pain-killing drugs. These deaden the nerves that relay sensations of pain from the lower body.

[~Mamaterra~]

I'm not surprised because anything that deadens nerves will also affect neurons as structurally they are similar. As the babies brains and the connections that exist in them continue to form until 36 months, any drug that affects neurons on a cellular level will also have an effect on the formation of these synapses.

[wifeandmom]

I had fentanyl with all three of my deliveries, and if my babies had wanted to nurse any more often, I think my nipples would have gone on strike.

I do see how the drugs given during labor/delivery/c-section could have this effect though, so it's certainly something to consider when deciding what birth choices to make.

Of course, mine were all scheduled sections, so perhaps the fact that my babies were out within minutes of administration of anesthesia vs. babies who are exposed to an epidural during hours of labor made a difference in their ability/willingness/eagerness to nurse.

As it was, all four were nursing within 20-45 minutes of birth, and only one had what I considered to be any real 'issues' with latching on. She was also the only one who subsequently refused to willingly take a bottle of EBM in later months, so I think it was more of a personality thing to be honest.

[OnTheFence]

I am not sure if I totally buy into this "research". Most the women I know who have had epidurals have had no trouble breastfeeding their babies. Maybe it is because they were committed from the onset to nurse. I can think of so many reasons why a baby would not nurse after birth. there are just so many variables. My youngest son latched on briefly while I was in recovery after a csection and then didn't nurse again for 13 hours. He just was not interested. When he was not sleeping he just wanted to look around and check his new world out. My two daughters though, got right onto the boob and never looked back! And one had a very traumatic birth experience.

[BugMacGee]

Both mine nursed like champs right away. I'm sure it might be an issue sometimes but certainly wasn't in either of my epidural-y births. With my second, my milk came in less than 48 hours pp because she never stopped nursing!!!

[ndunn]

Originally Posted by OnTheFence

I am not sure if I totally buy into this "research". Most the women I know who have had epidurals have had no trouble breastfeeding their babies. Maybe it is because they were committed from the onset to nurse. I can think of so many reasons why a baby would not nurse after birth. there are just so many variables. My youngest son latched on briefly while I was in recovery after a csection and then didn't nurse again for 13 hours. He just was not interested. When he was not sleeping he just wanted to look around and check his new world out. My two daughters though, got right onto the boob and never looked back! And one had a very traumatic birth experience.

Just watch the doctumentary "Delivery Self Attachment" by Dr. Lennart Righard. Whether you believe the "research" or not, the evidence is right there on the screen.

[Isamama]

I had an epi and a spinal before my c/s (don't know exactly what drugs went in them, but plenty I'm sure)---my daughter latched on and hasn't come off! LOL, OK an exaggeration but she breast feeds a ton!

[BugMacGee]

the evidence is right there on the screen.

Obviously it isn't universally a problem.

[FreeThinkinMama]

I had the epidural at 4cm, about 6 hours later my dd was born. I was induced with cytotec and pitocin so even though I desperately wanted to go natural I couldn't take it anymore.

I had very little support to breastfeed. Her pediatrician was pushing formula on me from the time she was 1 week old, I didn't have a lactation consultant, didnt know anyone in real life who bf etc. My dd had problems latching on and subsequently gaining weight & staying hydrated (for which she was hospitalized). She was a very sleepy baby and I tried everything I could think of to keep her awake for feedings. It broke my heart to stop nursing her, I was determined to make it work but I was made to feel by medical professionals that I was putting her life in danger by doing so. Of course hindsight is 20/20 and btw I now have a lactation consultant and new pediatrician for this baby

I really have no idea whether the epi was the cause of our bf'ing problems. I don't know to this day if she was tongue tied or what. Nobody ever mentioned that possibility to me. I read a lot about bf'ing back then but apparently not enough. I do know I had plenty of milk so supply wasn't the problem. I think it's possible the epi contributed our problems since it made ME so sleepy during labor. But more than anything it was the lack of support available to me from nurses and doctors who kept asking me why I didn't just put her on formula that really did us in. Even if the epi caused her to have problems at first, I feel if we had support we could have kept going.

So it makes me wonder whether this is a case of coorelation doesn't equal causation. So many women get epis nowadays but so few seem to have good support for breastfeeding. Many hospitals start pushing formula, glucose water and pacifiers from the beginning. I was told by nurses that nipple confusion wasn't real and a syringe would be too time consuming. Then there's the routine seperations for newborn procedures and nurses who encourage moms to feed on a schedule and keep their babies in the nursery so they can get sleep. Is it really the epi? Or is it just the lack of education and support from the medical community?

[skueppers]

I'm another in the "had an epidural, no problems nursing" camp. I had the epidural when I was fully dilated, and delivered the baby 3-4 hours later, by which time it had pretty much worn off. My daughter nursed soon after birth, and we never had any problems. I think I may have had a particularly low-dose epidural, since my hospital used patient-controlled administration, and I never pushed the button to get additional medication.

Hoping for a shorter labor this time around...

[skueppers]

According to news coverage mentioned in a separate thread:

http://www.mothering.com/discussions...d.php?t=574845

The researchers weren't sure whether the epidural affected the babies' ability to nurse, or whether mothers who opted not to have an epidural were more likely to be persistent about breastfeeding.

Too bad it's impossible to design a double-blind study on this subject!

[crazy_eights]

Originally Posted by ndunn

Just watch the doctumentary "Delivery Self Attachment" by Dr. Lennart Righard. Whether you believe the "research" or not, the evidence is right there on the screen.

I was going to mention this. This is not new research. Babies whose moms have had epidurals or other meds in labor can't do the same 'dance' to self attatch that those who were born unmedicated do. It's not that some can't compensate (as witnessed by the annecdotes of all the 'I had an epidural and baby nursed just fine' comments on both threads) but that the inborn mechanism appears to be interrupted.

[crazy_eights]

Originally Posted by BugMacGee

the evidence is right there on the screen.

Obviously it isn't universally a problem.

Again, you are comparing apples and oranges. What is evident 'on the screen' is the inborn drive to find the breast and self-attatch which was beautifully illustrated with a series of photographs in a recent Mothering magazine. No one is claiming that babies who are born to moms who had any medication in labor can't nurse ever!

[asherah]

Ds latched right on and nursed like a natural, minutes after birth. I had an epi. Didn't want it.. ended up with it because my MW sold me out, but that's another story.

I believe the research, but I don't think it would be very pursuasive to women considering epis out of fear of pain.

I didn't want an epi because I believed (and still believe) that the less intervention, the better for baby, period. And I believed that there were other, less risky ways to manage the potential pain.

I am not sure that doom and gloom predictions about nursing, despite all the epi-born babies who nurse perfectly well.. would have much of an impact. Seems like preaching-to-the-choir sort of information. "See I told ya epis were bad." Which is fine.. but there are better arguments to support natural birthing, I think.

That's my one regret about not having another. Would've liked to have had the birth I dreamed of.

[October16Mom]

Yup, here's another "had an epi, baby was wide awake and latched on great" poster. The key--I kept my epidural as low-dose as possible, only asked for a bolus once. That meant I could still feel a lot, but it did just enough to make the pain manageable. I talked to the anesthesiologist later, because he did such a great job. He said that what I did was much better for the baby than people who try to get their epis dense so they are completely pain free. I might add, the only side affect I had from my epidural was a rash from the tape they used ( I have sensitive skin!). The studies never mention that!

[cottonwood]

He said that what I did was much better for the baby than people who try to get their epis dense so they are completely pain free.

I can't tell you how many times I've heard people, including doctors, say that the epidural does not affect the baby. Nice to see a medical professional admitting otherwise.

[annettemarie]

Originally Posted by BugMacGee

the evidence is right there on the screen.

Obviously it isn't universally a problem.

Anecdote does not equal evidence, and very few things in this life are "universally" a problem.

[St. Margaret]

We we just talking about this in birth class, how the epi does stay in the infant for about 6 weeks (it's detectable-- I think it's filtering through the kidneys still) and how this interrupts the instinct of going to the breast. We learned about how at 4-6 weeks if you had to have an epi you might mark the time and see if there's a change.

Of course it is hard to distinguish whether the persistence of those moms had the imact or whether it was the meds. But it's nice to see spreading of the word, that epis DO affect babies, when everyone is always saying they don't at all, like, medically!

[Funny Face]

Don't you just love how nurses and doctors STILL tell you at the hospital that the epidural won't hurt the baby at all? or some go so far as to say it doesn't even reach them!

I think women who think they can't make it through labor without meds also forget that the MORE meds going to the baby the MORE the baby is affected. They think "Well, if I'm gonna get an epi anyway, why not get it early to avoid more pain?" but it would help the baby so much if those who aren't planning to go unmedicated at least waited as long as possible to get meds.

I ended up getting an epi at the end of my labor (despite my desire for natural birth) and my baby nursed like a champ, I don't know that that would have been the case if I had gotten my epi early on.

[Shawnee]

I may be one of the few here that thinks this could have been a problem for my baby. I had a spinal (assuming the same problem occurs with spinals?) and a c-section with ds. He wouldn't latch on after birth, just seemed to be kind of stunned. Now, that could have been the shock of being pulled from the womb before he was ready, or the shock of having his cord cut, or the shock of being deep-suctioned and everything else they did to him. Or it could have been the spinal medication.

There was a lot of pressure to get him feeding because of his low blood sugar. He never did root or open his mouth to nurse, I finally just kind of stuffed the boob into his mouth and then he started sucking. And for some reason it took weeks before he would open his mouth to nurse, I had to keep repeating the boob-stuffing procedure at every nursing session.