Let’s Chat…Labor Interventions–Part 3

You’re ready to welcome your baby to this world! You went into labor naturally or had an induction. The contractions are getting more intense. You may have a wonderful doula guiding you through your breaths. Or maybe you knew from the moment those two little pink lines appeared that you would have pain medication in labor. You’re ready to request an epidural, but what effect will that have on breastfeeding your baby?

What is an epidural?

An epidural is a small catheter inserted via a needle into your spine at a level that creates numbness in your abdomen down to your legs. Most epidurals use a combination of local anesthetic and narcotic (most commonly Fentanyl) delivered in small doses. Though it stays mainly in the epidural space, small amounts enter your bloodstream. These medications cross the placenta and can affect the neurobehavior of your baby.

Is it harmful to breastfeeding?

Several studies exist on the effects of epidural anesthesia and breastfeeding and the results vary. Here is what we know.

• The narcotics administered do reach your baby. They can cause your baby to be less responsive after birth. 
• Extra IV fluids alongside epidural analgesia can cause swelling of the breast tissue and make it difficult for your baby to latch. It can also impact the flow of milk in those early days.  
• An epidural may disrupt your hormone cycle and decrease the release of oxytocin, decreasing milk production, flow, and bonding with your baby.
• Narcotic medication can make you weak and numb. You may have trouble positioning your baby at the breast. 

How to be successful after an epidural

Although some studies show that mothers who receive epidural analgesia wean earlier than those who do not, there is no definite causation. In other words, the desire to breastfeed and breastfeeding support is a better predictor of success than whether or not the mother received an epidural. 

If you choose this method of pain control, be sure to follow through with the keys to successful breastfeeding:

• Provide skin-to-skin early and often
• Feed on demand
• Room in 
• Get help when needed

The use of pain medication during labor is controversial and also deeply personal. The best thing you can do is educate yourself and go into labor with an open mind. Speak with your provider about all your options and communicate your desires with your support person. Epidurals are effective for pain relief during labor but, as with everything, there are risks involved. Connect with your Lactation Consultant when needed and continue to follow us for more information. 

Read our other posts in the Labor Interventions series by clicking the button below.