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01-18-2013 at 3:52 PM
Icecream4m...
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Question about epidural and BF

I read so much about how having an epidural can cause problems with babies being able to latch on.  But the most of people I know who had either epidurals or c sections had no issues (and the one who did have an issue was still able to do so in the first few days).  Just wondering if anyone here who had a past epidural and planned to breastfeed had any inisights or suggestions (good experience / bad experience)...
 
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01-18-2013 at 4:00 PM
RussianMom...
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babies dont't really need to feed ASAP .... so if you're worried about baby being stoned and not being able to latch on, they have some time to perk up before needing to eat.
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01-18-2013 at 4:07 PM
SarahRae85
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I had an epidural with my first and we had no problems BFing, other than the normal learning process for both of us.

I also had general anesthesia (and morphine) due to emergency cesarean with my second and other than her being a little sleepier than normal, we BF without issue.
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01-18-2013 at 4:08 PM
UberBiz
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I had it all. Epidural, pitocin, then an emergency c-section. My daughter latched fine, and I wasn't able to hold her til about 5hrs after my surgery because I was so drugged up and not coherent. During that time she did have formula in the nursery. We nursed til she was 2 1/2.
 
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01-18-2013 at 4:13 PM
mle929
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I had an epidural and an unplanned c-section (had morphine) . We had no problems BFing and I nursed until she was 17 months.
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01-18-2013 at 4:13 PM
lkm2006
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I had an epidural but it had worn off hours before I delivered. My baby didn't latch but it certainly wasn't because he was "stoned". He was a preemie.

Look at it this way, the majority of women get an epidural and the majority of women successfully breastfed. Something has to go right!
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01-18-2013 at 4:22 PM
tmsgrl
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I have never heard of an epidural affecting a baby's latch for breastfeeding.  How are they connected?  An epidural is not a narcotic or anything like that if that is what you are thinking?  It blocks the mom's sensation of pain from below the waist.  I have never heard of an epidural affecting a baby, period.   I have had 3 babies and 3 epidurals and they all fed fine immediately after birth.
 
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01-18-2013 at 4:28 PM
Spacebunny...
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So, I was in a childbirth class with DD#1 and they showed a video showing the difference between a baby post medicated birth and a natural birth.  It nearly scared me into not getting an epidural (baby with meds was groggy, baby without went right to the breast to nurse.)  THEN the instructor explained that the video wasn't really about the epidurals but the meds they USED to give out, which crossed the placenta and yes gave you GroggyBaby. 

Epidurals don't have that impact.

I had one (it didn't really help my pain but whatever) and I nursed DD as soon as she was handed to me.  She latched fine & we did fine.  

Get the epidural if you want one.   You should be able to nurse the same as if you didn't have one.
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01-18-2013 at 4:34 PM
kielpinski...
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I had an epidural, followed by an unplanned c/s. As soon as they stitched me up and wheeled me back to recovery, I nursed DD for 30 min. We never had a latch issue and I BFed until she was 19 mos and I was 3 mos pregnant. I found that the lactation consultants at the hospital were more than happy to help us. I asked for them as soon as I got to my pp room.They even called us at home after leaving the hospital to check up on our progress.
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01-18-2013 at 4:49 PM
JenS2203
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I had an epidural with both girls. They were born alert and ready to latch. DD1 and I struggled, but that was more a learning curve than her being groggy. DD2 latched right away.
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01-18-2013 at 5:08 PM
AppleJacks...
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tmsgrl:
I have never heard of an epidural affecting a baby's latch for breastfeeding.nbsp; How are they connected?nbsp; An epidural is not a narcotic or anything like that if that is what you are thinking?nbsp; It blocks the mom's sensation of pain from below the waist.nbsp; I have never heard of an epidural affecting a baby, period. nbsp; I have had 3 babies and 3 epidurals and they all fed fine immediately after birth.

It contains fentanyl a narcotic and ropivacaine anesthetic
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01-18-2013 at 5:09 PM
AppleJacks...
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AppleJacks81:
tmsgrl:
I have never heard of an epidural affecting a baby's latch for breastfeeding.nbsp; How are they connected?nbsp; An epidural is not a narcotic or anything like that if that is what you are thinking?nbsp; It blocks the mom's sensation of pain from below the waist.nbsp; I have never heard of an epidural affecting a baby, period. nbsp; I have had 3 babies and 3 epidurals and they all fed fine immediately after birth.

It contains fentanyl a narcotic and ropivacaine anesthetic

Sorry, phone bumping just doesn't do punctuation justice lol.
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01-18-2013 at 6:05 PM
CelticWife
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I had a failed epidural with my first. Ds ended up in the nicu for over 4 hours. He never had an issue with latch.

With DD, I had an amazing epidural and she latched right away with no issues.

I am a newborn photographer, so I see lots of babies. I have seen a fairly equal amount of epidural moms, natural moms, and c section moms who had trouble bf. In my non professional opinion, the women with the most success had a partner who fully supported her, a hospital that was pro bf, and who didn't stress when she initially had.issues.
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01-18-2013 at 6:16 PM
BelhurstBr...
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RussianMommy:
babies dont't really need to feed ASAP .... so if you're worried about baby being stoned and not being able to latch on, they have some time to perk up before needing to eat.

Where did you read that? The sooner you initiate BFing, the better.

While small amounts of the medication given in an epi (yes, a narcotic is often involved) do cross the placenta the amounts are rarely sufficient to affect the baby. 

I believe there are more concerns about opiates, like Nubain, affecting the baby. In some cases, if dosed out too close to delivery, the baby may need to be given a medicine to counteract the side affects. 

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01-18-2013 at 6:19 PM
DC2London
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I had a picture perfect epidural and DS was alert and had no problem latching and feeding right away.
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01-18-2013 at 6:20 PM
OhSewCraft...
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Where have you read this information? What makes an epidural work doesn't pass through to the baby. Other IV drugs you may ask for/get can, but not an epidural. From everything I've read and been told by my doctor, an epidural does not "stone" the baby.


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01-18-2013 at 7:02 PM
kxp004
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OhSewCrafty:

Where have you read this information? What makes an epidural work doesn't pass through to the baby. Other IV drugs you may ask for/get can, but not an epidural. From everything I've read and been told by my doctor, an epidural does not "stone" the baby.

whoever told you that what makes an epidural work can't be passed to the baby is completely wrong... Everything goes to the baby regardless of what it is... that's why you can take acetaminophen but not ibuprofen, or drink alcohol or all the other things people will tell you that you can or can't have 

HOWEVER in low doses the baby is not usually AFFECTED by the epidural... and no statistically significant differences have been found between unmedicated and medicated births using an epidural in low dosages...  I believe I read the biggest issues were when the epi was given too close to delivery or in higher dosages...

 The Effect of Ultra Low Dose Epidural Analgesia on Newborn Breastfeeding Behaviors

  1. Sharon Radzyminski PhD, RN assistant professor and graduate program director*

Article first published online: 9 MAR 2006

DOI: 10.1177/0884217503253440

Issue

Journal of Obstetric, Gynecologic, & Neonatal Nursing

Journal of Obstetric, Gynecologic, & Neonatal Nursing

Volume 32, Issue 3, pages 322–331, May 2003
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01-18-2013 at 7:26 PM
laurakaz13
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Had an epidural and had no problem BFing immediately.  DD has no problem latching. 
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01-18-2013 at 7:36 PM
dande2129
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Had an epidural that didn't take, gave birth to DS, he wouldn't latch. Had latch issues even with the help of lactation consultants in the hospital, and he never breastfed.

ETA: At 3 1/2 months, when I had had it with exclusively pumping, I tried the nipple shield again and DS began to nurse. We did that for two weeks until he decided that he didn't want to anymore, and stopped taking even the shield. 

I blame my inverted nipples and lack of motivation to continue to try for the reason that we didn't exclusively BF, not the epidural. He was very alert after he was born, FWIW. 
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01-18-2013 at 7:43 PM
JuliaBug
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I had an epidural and was able to BF DS in the delivery room within 30 minutes or so. Neither of us ever had a problem with BFing and I was able to nurse him until he was 14 months. 
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01-18-2013 at 7:54 PM
sucrets4
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DD was a preemie and didn't have enough stamina to nurse for a few weeks, but she tried and I had a section.  Granted, it was a few days after birth, but she did it.

We went on to have a successful nursing relationship for 2.5 years. 
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01-18-2013 at 7:57 PM
candreco
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My epidural had zero effect on BFing for DD and I.

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01-18-2013 at 7:58 PM
mabenner1
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RussianMommy:
babies dont't really need to feed ASAP .... so if you're worried about baby being stoned and not being able to latch on, they have some time to perk up before needing to eat.

That isn't true. Baby should be put to breast as soon as possible to help stimulate milk production.
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01-18-2013 at 8:01 PM
Icecream4m...
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Wow - I'm glad I wrote this and got such positive responses.  I guess I've been reading too much.  I read this in my breastfeeding book, saw it in the childbirth class movie and in a variety of other places.  But as I said - I hadn't heard any first hand  examples of this.  I feel better.  Thanks! 
 
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01-18-2013 at 8:28 PM
BrittKav
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I had an epidural with both my kids. My firstborn was very alert and breastfed constantly while we were in the hospital. She continued to be an alert, high-needs baby throughout her first year. My secondborn was a sleepy baby in the hospital, but still breastfed easily when she was awake. She went on to be a calm, content baby for her first year. So the differences in the hospital were just their personalities, not anything to do with an epi. I breastfed both for quite a while (2.5 years for DD1 and 16 months for DD2).
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01-19-2013 at 12:58 AM
sararn2004
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AppleJacks81:
tmsgrl:
I have never heard of an epidural affecting a baby's latch for breastfeeding.nbsp; How are they connected?nbsp; An epidural is not a narcotic or anything like that if that is what you are thinking?nbsp; It blocks the mom's sensation of pain from below the waist.nbsp; I have never heard of an epidural affecting a baby, period. nbsp; I have had 3 babies and 3 epidurals and they all fed fine immediately after birth.
It contains fentanyl a narcotic and ropivacaine anesthetic

DRUGS WHICH DO NOT CROSS THE PLACENTA

  • All paralytics
  • Glycopyrrolate
  • Insulin
  • Heparin

DRUGS WHICH CROSS THE PLACENTA
Potentially Dangerous

  • Opiates (morphine, fentanyl if > 1 ucg/kg)
  • Benzodiazepines
  • Ephedrine (increased metabolism)
  • Local anesthetics
  • Atropine
  • B-blockers

Safe

  • Propofol
  • Thiopental
  • Ketamine
  • Fentanyl at < 1 ucg/kg
  • Epidural opiates (fentanyl, sufentanil)

 

 Notice the last two bolded bullets. Pretty sure the anesthesiologist is aware of this.

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01-19-2013 at 4:16 AM
gfam23
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OhSewCrafty:
Where have you read this information? What makes an epidural work doesn't pass through to the baby. Other IV drugs you may ask for/get can, but not an epidural. From everything I've read and been told by my doctor, an epidural does not "stone" the baby.


It doesn't "stone" Mom, either.
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01-19-2013 at 11:13 AM
LovinTim91...
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Had an epidural with my first, and spinal for a c-section for my second.  Both nursed shortly after birth, right around the time when i was beginning to get feeling back in my legs.  Neither appeared to be stoned.  I didn't feel stoned either.  Haha maybe that would've made the experience more pleasant though!!! :)
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01-19-2013 at 3:10 PM
AppleJacks...
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sararn2004:

AppleJacks81:
tmsgrl:
I have never heard of an epidural affecting a baby's latch for breastfeeding.nbsp; How are they connected?nbsp; An epidural is not a narcotic or anything like that if that is what you are thinking?nbsp; It blocks the mom's sensation of pain from below the waist.nbsp; I have never heard of an epidural affecting a baby, period. nbsp; I have had 3 babies and 3 epidurals and they all fed fine immediately after birth.
It contains fentanyl a narcotic and ropivacaine anesthetic

DRUGS WHICH DO NOT CROSS THE PLACENTA

  • All paralytics
  • Glycopyrrolate
  • Insulin
  • Heparin

DRUGS WHICH CROSS THE PLACENTA
Potentially Dangerous

  • Opiates (morphine, fentanyl if > 1 ucg/kg)
  • Benzodiazepines
  • Ephedrine (increased metabolism)
  • Local anesthetics
  • Atropine
  • B-blockers

Safe

  • Propofol
  • Thiopental
  • Ketamine
  • Fentanyl at < 1 ucg/kg
  • Epidural opiates (fentanyl, sufentanil)

 

 Notice the last two bolded bullets. Pretty sure the anesthesiologist is aware of this.

while those drugs do cross the placenta, they have a harder tome getting out of your epidural space. It's called the blood brain barrier, and its a reason why it's hard to treat conditions like meningitis and cancer of the central nervous system. Drugs cannot penetrate as easily through it, which is why you need the infusion directly into the spinal area. Which is probably why a previous poster mentioned that their doctor said it wouldn't reach the baby. 
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01-19-2013 at 4:09 PM
sararn2004
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AppleJacks81:
sararn2004:

AppleJacks81:
tmsgrl:
I have never heard of an epidural affecting a baby's latch for breastfeeding.nbsp; How are they connected?nbsp; An epidural is not a narcotic or anything like that if that is what you are thinking?nbsp; It blocks the mom's sensation of pain from below the waist.nbsp; I have never heard of an epidural affecting a baby, period. nbsp; I have had 3 babies and 3 epidurals and they all fed fine immediately after birth.
It contains fentanyl a narcotic and ropivacaine anesthetic

DRUGS WHICH DO NOT CROSS THE PLACENTA

  • All paralytics
  • Glycopyrrolate
  • Insulin
  • Heparin

DRUGS WHICH CROSS THE PLACENTA
Potentially Dangerous

  • Opiates (morphine, fentanyl if > 1 ucg/kg)
  • Benzodiazepines
  • Ephedrine (increased metabolism)
  • Local anesthetics
  • Atropine
  • B-blockers

Safe

  • Propofol
  • Thiopental
  • Ketamine
  • Fentanyl at < 1 ucg/kg
  • Epidural opiates (fentanyl, sufentanil)

 

 Notice the last two bolded bullets. Pretty sure the anesthesiologist is aware of this.

while those drugs do cross the placenta, they have a harder tome getting out of your epidural space. It's called the blood brain barrier, and its a reason why it's hard to treat conditions like meningitis and cancer of the central nervous system. Drugs cannot penetrate as easily through it, which is why you need the infusion directly into the spinal area. Which is probably why a previous poster mentioned that their doctor said it wouldn't reach the baby. 

Agreed. It's also why one doesn't feel like they've had narcotics when they've had an epidural. I've had intravenous fentanyl before(at a dose slightly higher than 1 umg/kg and felt the narcotic euphoria. I've also experienced morphine IV during my ruptured ectopic, talked about doped up. The epidural doesn't make you feel that way at all. Very little gets out of the epidural space, into the intravenous system, then into the placenta, and fetal circulation. My child born when I had an epidural had a higher APGAR score at 1 min than my other one that I had without an epidural (which doesn't really say anything since so many other factors contribute, but if she were doped up, she wouldn't have scored so well.
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