Effect of Labor Epidural Analgesia with and without Fentanyl on Infant Breast-feeding

Beilin, Yaakov; Bodian, Carol; Weiser, Jane; Hossain, Sabera; Arnold, Ittamar; Feierman, Dennis E.; Martin, Grégory; Holzman, Ian R.

doi:10.1097/00000542-200512000-00016

Cited by 137 publications

(71 citation statements)

References 24 publications

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“…Intrapartum analgesia may also have an impact on breastfeeding, and consideration needs to be given to the type and dose of analgesia. 6,[21][22][23] Epidural analgesia, intramuscular opioids, exogenous oxytocin, and ergometrine have all been associated with lower rates of breastfeeding initiation. 24 (I, II-2, III)…”

Section: Prenatalmentioning

confidence: 99%

ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term, Revision 2013

Holmes

McLeod²,

Bunik

2013

Breastfeeding Medicine

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Section: Prenatalmentioning

confidence: 99%

ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term, Revision 2013

Holmes

McLeod²,

Bunik

2013

Breastfeeding Medicine

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“…In a systematic review, Leighton and Halpern (2002) concluded that EDA does not affect breast-feeding initiation or management. The question of whether EDA would still be linked with breastfeeding failure was raised again when Beilin et al (2005) noted in a RCT that those women who received more than 150 µg of fentanyl in the EDA were less likely to continue breast-feeding at 6 weeks after delivery. In this respect, one could speculate that an ultra-short analgesic may have an advantage over longer acting medications.…”

Section: Effects Of Maternal Analgesia On the Neonatementioning

confidence: 99%

Intravenous patient-controlled analgesia with remifentanil in early labour

Volmanen¹

2011

Acta Anaesthesiologica Scandinavica

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Cover design Raimo Ahonen JUVENES PRINT TAMPERE 2010Volmanen, Petri, Intravenous patient controlled analgesia with remifentanil in early labour. AbstractIn four prospective clinical trials, 114 parturients used intravenous patient-controlled remifentanil analgesia during the 1 st stage of labour. The median effective dose per bolus was ascertained to be 0.4 μg/kg and the pain scores were reduced with this by a median of 2 on a numerical scale (0-10). Compared with nitrous oxide, 15 parturients included in a cross-over study reported a larger reduction in pain scores during remifentanil analgesia (1.5 vs. 0.5, p = 0.001) and better pain relief scores (2.5 vs. 0.5 on a ranked five point scale 0-4, p < 0.001). In a parallel study including 45 parturients, epidural analgesia (EDA, 20 ml bupivacaine 0.625 mg/ml and fentanyl 2 μg/ml) was associated with lower pain scores (5.2 vs. 7.3 with remifentanil, p = 0.004) but variables related to satisfaction with analgesia (pain relief score, proportion of mothers with desire to continue with the given medication and termination of the study due to inadequate pain relief) were similar. A comparison of two methods for timing the remifentanil bolus during the uterine contraction cycle suggested that delaying the bolus does not improve analgesia. A period effect was noted in the cross-over trial with higher pain scores and increased drug consumption during the second study period suggesting acute hyperalgesia.Side effects of remifentanil analgesia included respiratory depression warranting oxygen supplementation in 33% of parturients. Sedation was experienced by the parturients using remifentanil and this was scored as stronger than sedation during nitrous oxide and EDA. The number of parturients with nausea did not increase during remifentanil analgesia. Other maternal side effects included dizziness, a difficulty in visual focusing and itching. Foetal heart rate tracing abnormalities were noted. The incidence of abnormal tracings and decreased UapH were not different, however, from that observed during nitrous oxide or EDA. Apgar scores at 1 and 5 minute indicated no neonatal depression. Keywords

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“…The newborns of women who receive certain kinds of epidurals (that include a narcotic drug) have more problems breastfeeding in the first hours, days, and weeks after birth (Beilin et al, 2005;Jordan, Emery, Bradshaw, Watkins, & Friswell, 2005;Lieberman & O'Donoghue, 2002;Radzyminski, 2003Radzyminski, , 2005Torvaldsen, Roberts, Simpson, Thompson, & Ellwood, 2006).…”

Section: Epidural Analgesiamentioning

confidence: 99%

Care Practice #4: No Routine Interventions

Lothian

Amis²

2007

jpe

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This updated edition of Care Practice Paper #4 presents the evidence for risks of routinely intervening in normal physiologic labor and birth. The authors review evidence related to the routine use of restrictions on oral intake, intravenous lines, continuous electronic fetal monitoring, artificial rupture of membranes, pharmacologic augmentation of labor, epidural analgesia, and episiotomy. Medical indications for each intervention are listed. Women are encouraged to avoid routine interventions in labor unless interventions are medically indicated.

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Effect of Labor Epidural Analgesia with and without Fentanyl on Infant Breast-feeding

Abstract: Among women who breast-fed previously, those who were randomly assigned to receive high-dose labor epidural fentanyl were more likely to have stopped breast-feeding 6 weeks postpartum than woman who were randomly assigned to receive less fentanyl or no fentanyl.

Cited by 137 publications

References 24 publications

ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term, Revision 2013

ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term, Revision 2013

Intravenous patient-controlled analgesia with remifentanil in early labour

Care Practice #4: No Routine Interventions

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