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Things that make you go hmmm…….
A guest blogger offered this article with some interesting information on potential postpartum effects of epidurals on breastfeeding. I didn’t have an epidural at either of my births, but after reading this, I sure am wondering about the experience of new moms who did….
“The precise effect of epidural medication on breastfeeding is still uncertain and there are numerous studies underway to uncover the truth. The practice of using epidurals during birth has become very common and is more so among women having babies for the first time, who are privately insured, cared by obstetricians and who deliver a healthy infant. Many lactation consultants and doctors believe that epidurals have the ability to hinder if not totally diminish the baby’s ability to suckle in the first hour of birth. This may or may not be true for all babies but has been found to be true for majority of the babies when mothers have used epidurals during birth. This could happen because of the fact that amounts of the medication enter the mother’s blood stream and pass through the placenta into the baby’s circulation. Common epidural medications given during birth include fentanyl, an opioid narcotic and a regional anaesthetic. Morphine is commonly used if the birth is a caesarean.
While applying an epidural, a local anaesthetic is injected through the lower back into the epidural space around the spinal cord. Due to this, the nerves bringing sensation from the uterus and birth canal are numbed but unfortunately, so are the nerves controlling the pelvic muscles and legs. The woman is unable to move her legs and consequently, unable to push her baby out in the second stage of labor. Although, epidurals do reduce the pain considerably but there are side effects to using epidurals especially for the mother. The major one is the drop in the mother’s blood pressure right after the epidural is applied, which may hinder the oxygen supply to the mother’s and the fetus’s vital organs. Studies have shown that the use of epidurals made the first week after birth harder for the mother, increasing the chances that they would stop breastfeeding the baby sooner.
Infants of un-medicated mothers naturally start breastfeeding by massaging the mother’s breasts with their hands, self-latching and suckling usually within the first hour. Babies of medicated mothers however, may not show a similar behaviour, they may require additional help to latch on and suckle. Sometimes a baby may suckle but not be able to latch on properly. If a baby does not learn to latch properly, it may lead to future problems for the mother who may have to express milk using a breast pump to fulfill the needs of the constantly hungry baby.
Of course there are cases, such as in caesarean births, where epidurals and medication may be imperative. That said, many doctors discourage the routine use of epidurals. Alternatives can be used to reduce the pain, including self-hypnosis and gentle massaging of the back, arms, and legs. Midwifes, nurses, birthing coaches and other support people can often work wonders to mentally and emotionally guide the mother through the birth without medication.”
I’ve heard from friends on both sides of the fence. One mom said her epidural never worked in the first place. Another (great ) mom said she would happily give birth again only if she could have another epidural, potential negative effects be d*****. So now I’m really curious.
If you had an epidural, I would love to hear from you about your experience on this blog! Did you find that it interferred with your babies’ ability to nurse? Do you think there was any signicant effect on your postpartum experience?
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I had twins by c-section since they were both butt down, one on top of the other. And big. Anyway, my epi worked, thank goodness, and didn’t affect my breastfeeding that I am aware of. I don’t have anything to compare it to since these are my only kids.
But the kids latched fine after about 4 hours. I didn’t get to be with them right away because after the epi wore off and they started shooting me up with morphine for the pain we found out….morphine doesn’t WORK for me. Now, this was a pretty big bummer, I was in heaps of pain, and using every meditation I’ve ever known to get through it. Kids were being bathed and cuddled by their pop and other family this whole time.
FINALLY, they found a drug to give me which worked wonders. Both babes latched right on and sucked their way to happiness until 20 months. No formula. Maybe I was lucky? I had lots of breastfeeding luck – very little pain and plenty of juice!
I had two babies; one with an epidural, one without (J came so fast that there was no time). Both were complicated in ways; my first was 6 weeks early – I had the epidural but was easily able to push Alex out w/in 45 minutes or so of pushing. I could not feel anything, but he was also small (5 pounds, 4 1/2 ounces).
J was full term and I had asked for an epidural, but she came so fast (5 cm to delivery in 12 minutes!), it just didn’t happen. I did try to nurse her right after she was born, but she wasn’t very interested. Then I hemorrhaged (I had a bit of retained placenta), lost a lot of blood and required a D&C to fix (they tried removing the bit by hand – again, I had had no drugs – this was EXTREMELY painful, and it did not work, so off to surgery I went). I wound up quite anemic although I did receive 2 units of blood after surgery.
Now, back to Alex – because he was born so early, he did not yet have a sucking reflex when he was born. I pumped every three hours around the clock and the hospital staff gavaged him (fed him through a tube w/ my milk). We practiced nursing every day and eventually taught him to nurse via that and a method called “finger-feeding” (this was 1998; I have no idea if this is still done). Oddly, having the preterm experience made my breastfeeding experience much easier than it might have otherwise been; I had nurses and lactation consultants any time I wanted them for three weeks – until Alex was discharged. He nursed until he was almost 4 years old.
It’s not possible to draw conclusions from my anecdotes, but I can’t say for myself that *not* having an epidural was any more beneficial than having one in this regard. It’s extremely difficult to do Evidence Based Practice in the field of obstetrics/l & d, as women labor differently and do things differently – it’s hard to cut out the variables. Added to that is the confounding variables of medical problems, such as those I had. Most women don’t have them, but when they appear, they can make a “normal” birth suddenly veer into a disaster and a seemingly high risk birth have hidden benefits. I don’t think it’s as cut and dried as anyone would like to think.
What I would not like to see is women blaming their epidurals on their having difficulty breastfeeding and spending time feeling guilty about that, when it could also be any number of things that are co-variables. For example, hospitals that do a lot of epidurals may be very high-tech and fast-paced places and may not take enough time to help the new mother learn to breastfeed.
I’d be far more wary of drugs like Nubain or Stadol that cross the placenta much more readily (especially because there are more of them in the mother’s system) than epidurals. Hospitals routinely keep Narcan on hand to give to babies to reverse the soporific effects of this type of drug. That’s not to say that I don’t think anyone should ever use those particular drugs (I’m not judging), but my understanding is that the amounts of the drugs used in epidurals are much smaller than with Narcan, etc.
So that’s my personal experience, mixed with a bit of what they taught us in my OB nursing class (I’m a student nurse).
Sorry I wrote for so long!
I love the way you put that: “Very little pain and plenty of juice!” Awesome to hear you were able to breastfeed easily despite the medications.
Hi Sara,
Thanks so much for sharing your story! No worries about the length – I love to read whatever people have to say. I appreciate your insights about all the variables involved, and agree that it would be counterproductive for women to feel guilty about having medication. Far better for women to have the lactation help they need to resolve any breastfeeding issues in the easiest possible way!
I just love articles that try to scare moms into going all natural. I had three kids, all three were with epidurals, and all three started nursing immediately. And I do mean immediately. They could barely wait for me to snuggle and look at them before they were trying to latch onto anything that came close to their mouths.
I had intense back labor with my first, so that epidural was a gift from God. Trust me, gentle massage and hypnosis could not cut through that pain! I probably could have gone natural with the other two, but my experience was so much more enjoyable with the first that I opted to not be entirely wiped out by the labor experience. I could still push, I could still feel pressure, but the pain was gone and I was a much, much happier woman. When our families came in to meet our new little one minutes after they arrived, I was all smiles and happy to see them.
If a natural childbirth option is what you want, more power to you. But I was very realistic in knowing what I could handle and what my husband could handle as well. One of my favorite bits of advice that I read was “they don’t give special medals to women who go natural”. Do it for yourself, if that’s what is good for you. And don’t judge people that go a different route because it is good for them. And please don’t try to scare people into going your way just because you think it is better. Research, talk to your doctor and make up your own mind!
Excellent comment! My intent was never to try to scare anyone into going “all natural.” I completely support women’s birth choices, medication or not. However, my close friends who had epidurals had chosen not to breastfeed. So when a guest blogger presented the information included here, I became very curious to hear real life stories about women who did after an epidural. Thanks so much for sharing your experience – it’s wonderful to know that all three of your children were able to nurse immediately.