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Breastfeeding & Epidurals

Dear and beautiful mothers,

I cannot encourage you enough to take charge of your pregnancy, childbirth and postpartum. Evidence Based Birth is a website created to educate women and to empower their decisions with only but evidence.

In the article and video, "Effect of Epidurals on Breastfeeding," Rebecca Dekker provides us information about currently studies about the topic.

I encourage you to watch the entire video, there are lots of important points such as:

1. "It is true that the medications in the epidural can cross the placenta and get into the newborn’s circulation. These medications have also been found in breast milk. That information comes from a statement from ACOG, the American Congress of Obstetricians and Gynecologists."

2. " Researchers have theorized that there’s a couple different ways that epidurals could theoretically affect breastfeeding.

A. "First, the medications cross the placenta and could potentially affect the newborn’s ability to suck and latch onto the breast."

B. "Second, the medications could lead to the mother developing a fever during labor. Fevers in the mother are linked to lower Apgar scores in the baby, and potentially more health problems in the newborn that could make breastfeeding more difficult for the baby."

C. "Third, the medications could potentially influence the mother’s hormones, which may impact breastfeeding."

D. "Fourth, epidurals are linked to higher rates of vacuum and forceps delivery, which could impact breastfeeding because often those mothers need to have more stitches done down there after the vacuum or forceps, and because they’re having to have that repair done of their perineum, that might delay breastfeeding or skin to skin contact in some cases. Or the baby may have head or neck bruising that makes it more difficult for them to breastfeed."

E. "Another potential link are the longer second stages of labor - the longer pushing phases that we see with an epidural. This could potentially tire the mother and baby and make it more difficult for them to breastfeed. We’re going to talk more about longer second stages of labor with epidurals in a separate video."

F. "Finally, IV fluids are given in higher amounts when you have an epidural. They give the IV fluids to help keep your blood pressure up because low blood pressure is a side effect of the epidural. Having excessive IV fluids during labor could lead to painful breast swelling after the birth, also known as engorgement, or edema, a more severe form where you have extremely swollen breasts. This can make it more difficult for you to breastfeed your baby."

G. "Also, IV fluids given during labor mean that the baby’s going to be born with a little bit extra fluid onboard, and when the baby urinates off that fluid or pees off that fluid, healthcare professionals might think the baby is losing weight and they might recommend formula, which might then influence the breastfeeding relationship."

3. "In 2016, a group of researchers led by someone named French pulled all of the studies that had ever been done on this topic to try and figure out if there is a relationship between epidurals during labor and breastfeeding. [...However], the research evidence on this topic is very controversial. Epidurals are very effective pain management tools during labor, and there are many factors that can affect your breastfeeding success. It’s possible that epidurals might be one of those factors. It’s possible from looking at those two randomized trials to assume that a very high dose of epidural medications may negatively influence breastfeeding even if you’ve already successfully breastfed in the past. However, low dose epidurals, at least so far, don’t seem to have that same problem."

I hope this is helpful and I encourage to watch the video.

I am looking forward to continue helping you with evidence based birth information.


Dayana Harrison

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