Sunday, February 19, 2012

8 Ways Natural Birth Is Good For Breastfeeding

(This is one of our Mama Birth community mothers nursing her baby born via cesarean.  Go mom!)
Dare I say it?  Birthing naturally gives you a head start on the breastfeeding relationship.

There, I said it. 

Feels good to get it out of my system. 

Are there home birthing moms who never are able to successfully breastfeed?  Of course.  Are there c-section moms who nurse with ease?  Yes again. 

But let's be real, an overly medicalized birth can most certainly throw a wrench into the natural process of breastfeeding your baby.  Here are eight ways that breastfeeding can be disturbed by birth interventions and drugs. 

1)  Pitocin can increase jaundice in the newborn -

Pitocin must be one of the most used drugs in obstetrics.  Surly it has it's place and has saved many a life for postpartum hemorrhage.  But lets talk about JAUNDICE and the role of Pitocin in it.  The package insert for Pitocin notes that:

"The following adverse reactions have been reported in the fetus or neonate:
Due to induced uterine motility: Due to use of oxytocin in the mother:
  Bradycardia   Low Apgar scores at five minutes
  Premature ventricular contractions and other arrhythmias   Neonatal jaundice
  Permanent CNS or brain damage   Neonatal retinal hemorrhage
  Fetal death
  Neonatal seizures have been reported with the use of Pitocin."      


Obviously there are a few potential side effects, but I want to focus on jaundice.  The National Library of Medicine points out that jaundice can cause excessive sleepiness in the newborn and "poor feeding", among other things. 

Any mother who has had a jaundiced baby knows that it is HARD to nurse a baby that is lethargic.  An overly tired and jaundiced baby kind of interrupts the whole natural "fussy hungry baby needs food" thing that babies usually use to tell mama, "Hey- feed me!"

Instead, the baby just sleeps.  And sleeps.  And sleeps. 

Then mama has to wake baby and struggle to keep them awake during feedings.  Then baby needs to sleep on a special light blanket rather than near his food source.  Then mama has a hard time making enough milk. 

And thus we begin a difficult breastfeeding relationship because of a very common DRUG given to mothers. 

Pitocin- Jaundice- Difficulty Breastfeeding


2) Pethidine (also known as Demerol) in labor can decrease infant ability to suck-

This study found that infants with higher concentrations of this drug in their system were less likely to suck after birth.  

This Swedish study found that rooting and sucking behaviors in the newborn were depressed in mothers who had been given Pethidine in labor. 

This study also found that Pethidine should be restricted in labor due to the negative impact it had on breastfeeding.  

3)  Stupid newborn procedures (immediate washing, separation, shots, etc) that take baby away from the mother have been shown to have a negative impact on breastfeeding-

This Medscape article points out how important immediate skin to skin contact between mother and baby is for the breastfeeding relationship. 

Keeping your baby close to you, delaying (or totally avoiding) needless separation and washing is one way that you can help ensure a longer and easier breastfeeding relationship.  Find out your hospitals policies on this.  If you have a c-section is separation mandatory?  What about if you are medicated?  You need to know, because there is a good chance it can impact your nursing relationship. 

4)  Epidurals can negatively impact breastfeeding initiation-

This study found that women who delivered vaginally but received an epidural were significantly more likely to have their babies given a bottle while in the hospital, despite breastfeeding attempts. 
"Conclusions: Labor epidural anesthesia had a negative impact on breast-feeding in the first 24 hours of life even though it did not inhibit the percentage of breast-feeding attempts in the first hour."


5)  Women who received drugs in labor are much less likely to be nursing at 24 weeks postpartum-

This cohort study found that medications in labor had a large impact on both initial success and continuation of breastfeeding. 
"Women in this cohort who had epidurals were less likely to fully breastfeed their infant in the few days after birth and more likely to stop breastfeeding in the first 24 weeks. Although this relationship may not be causal, it is important that women at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support."
How many women who plan on breastfeeding actually know this before they get that epidural?

6)  C-section is a barrier to breastfeeding-

This study found that mode of delivery did impact breastfeeding, c-section mothers having more difficulty than vaginally delivering mothers.
 "Conclusions:  The findings confirmed that cesarean section was a significant barrier to the implementation of Baby Friendly Hospital Initiative Step 4 and that hospital practices were amenable to changes that enabled its implementation regardless of the mode of delivery."
 Step four of the Baby Friendly Hospital Initiative is,

"- Help mothers initiate breastfeeding within one hour of birth."  


7)  Fentanyl may impede breastfeeding-

This study found that intrapartum fentanyl seemed to "thwart" breastfeeding. 
"While inhalation analgesia is rapidly eliminated from both mother and neonate, other analgesics cross the placenta and enter colostrum. Therefore, intrapartum analgesics may exert subtle effects on both infant and mother, hindering initiation of breastfeeding."
8)  C-section can delay the onset of milk production-

Mom's know that it takes milk supply a few days to begin.  Until your milk "comes in" your baby can thrive with colostrum.  What few women know is that c-sections can make this waiting period between birth and milk supply take longer. 

This study found just that. 
"Prospective observational studies indicate that both maternal and fetal stress during labor and delivery (e.g., urgent Cesarean sections or long duration of labor in vaginal deliveries) are associated with delayed onset of lactation."
 ~~~
You know what is the saddest thing about writing this post?  These are only eight things I found regarding drugs and interventions in birth that negatively impact the breastfeeding relationship.  There are literally dozens more studies on the same subject.

If you have a strong desire to breastfeed your baby, you may want to further research the impact of common drugs and procedures on your ability to do so.

Blessings on your breastfeeding journey no matter how your birth goes!

7 comments:

Rachel @ Lautaret Bohemiet said...

Great post. This is information that a lot of women NEED to know and simply don't. I have so many friends (so many) that made their birthing choices based on what felt right at the time, but only much later learned that what felt right at the time would feel horribly wrong later in terms of recovering, breastfeeding, etc. Yes, women should be able to birth HOWEVER they want. But they should be informed when they make that choice, or else it really isn't even a choice at all.

This information was great. I liked having it all in one compact little post like that.

Unknown said...

Don't forget about antibiotics. I had a c-section, and a few weeks later my baby and I got a ridiculous case of thrush. After spending all that time trying to get over the problems with nursing that you mentioned with a highly medicated c-section, it was terrible being set back so far again. I found out later from my la leche league leader that the antibiotics given intravenously during labor, and in much higher doses for c-sections, can cause a yeast imbalance in baby's mouth, which can lead to thrush, which can infect mom and be incredibly painful (as we found out). When I got my i.v. at the hospital before surgery, I asked the nurse if there were any downsides or side effects to what I was being given, and she said it was perfectly harmless. I think she really believed what she was saying, but my baby and I battled super painful thrush for weeks because of it.

melissa v. said...

Yes! Excellent post and I linked it on Mothers of Change for our Sunday Surf. Very comprehensive and well researched. Thank you! And Unknown is exactly right about antibiotics and thrush; been there, had that. Thrush is so painful it is no wonder women often stop breastfeeding through it, and it must be torture for the babies, who often have it through their entire GI system! =)

Rachel said...

I have to wonder if the decrease in women breastfeeding who had pitocin isn't somehow connected to the roll of oxytocin in bonding and breastfeeding. Women (and their babies) who give birth without pitocin are flooded with high levels of oxytocin where as synthetic pitocin doesn't cross the blood-brain barrier, has a very short half-life in the body, disrupts the body's natural production of oxytocin, and floods the oxytocin receptors in the brain and elsewhere in baby, possibly making them insensitive to oxytocin later in life. We have no idea of the full impact that may have on breastfeeding, much less long-term health.

Christie said...

I did not have a natural birth but am happy to report our early breast feeding attempts were successful and that I ended up going solidly for two years plus, with the plus part being night feedings for an additional year. Breast feeding was something I wanted to do for at least six months and I was lucky enough to have it work. Good luck to all who make the attempts and congrats to those who are unfortunate enough to have it work out.

Anonymous said...

I definetly agree that natural birth is 10 times better than a drug induced, c-section etc. how ever my son its an exception to the rules. I was a young mom, 20 to be exact but I had a natural birth plan. Included was drug free, water birth, focal points, quiet, dim room! My ob was old he graduated obstetrics in 1963, his way of doing things was "get the baby out asap, make as much $ as possible" which I didn't kno. How ever my pregnancy was very organic I wouldn't dye my hair, paint nails, use microwaves, eat red food dye etc. on my fire date my ob stated he wanted me to come in to see if we could get the labor going "naturally" for fear the baby was too large for my 5'3" frame weighing all of 129 lb's @ my due date. I got in at 7am and by 10 he had already started pitocin+ broken my water against my wishes and bullied me to the point of giving in he told me to have a c-section I told him I would only ever consider that if it was an absolute emergency 1 1/2 hours later with 16 staples hip to hip I was holding my baby boy I regret giving in and my soon was slightly jondice (no need for special lights) but I recovered naturally after a major surgery WITH OUT PAIN MEDS!! I refused to poison my son with narcotics thru my brest milk! He successfully nursed for 18 months, and I had enough of a milk supply I even donated to milk banks! I wish I had known a little bit more back then.

Bollwinkel Blog said...

So interesting! I had an epidural and pitocin with my first baby and had so many problems with breastfeeding. I never knew pitocin could affect having jaundice. It is definitely hard to teach a lethargic baby to eat, but you can. It took a good 6 weeks to overcome our challenges.

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