Women who receive fentanyl analgesia during labor may be less likely to breastfeed their infants, according to UK investigators. Based on their findings, they propose that women given this type of analgesia during labor should also receive support to successfully establish breastfeeding in the hospital.

There is currently some evidence that fentanyl and similar analgesic drugs have an impact on infant feeding, Dr. Sue Jordan from the University of Wales in Swansea and colleagues note in their report published in BJOG: an International Journal of Obstetrics and Gynecology.

To look into the matter, the team reviewed the medical records of a random sample of 425 healthy women who delivered a healthy full-term infant, their first, in 2000. At discharge from the hospital, 45 percent of the women were exclusively bottle-feeding their infants and none of the women began breast-feeding after going home.

In analyses accounting for factors known to influence infant feeding, fentanyl during labor, particularly at higher doses, appeared to impede the establishment of breastfeeding, the investigators report.

Jordan and colleagues caution, however, that any impact of analgesia during labor on infant feeding is unlikely to be uniform across the population studied. In the current study, for women who intended to bottle feed, treatment with fentanyl made no difference and delivery by cesarean section rather than type of analgesia had a greater influence on the type of infant feeding.

On the other hand, “where other factors favoured breastfeeding, intrapartum fentanyl appeared to thwart the mothers’ intentions,” the team notes.

For example, for a woman planning to breastfeed and delivering vaginally, administration of fentanyl increased the probability of bottle-feeding by 63 percent.

The authors note that up to 50 percent of women are given fentanyl or similar analgesic drugs during labor, and suggest that using only local anesthetics could increase breastfeeding rates.

SOURCE: BJOG: an International Journal of Obstetrics and Gynecology, July 2005.