Labor Medications: Oh yes, it affects breastfeeding.

by Laurie Chamberlin CD, ICCE, CLE

‘Will the pain medication I have in labor affect my baby?” asks my client Olivia with curious eyes. I think I know the answer she is hoping for and I don’t think I can give it to her. “Yes” I reply, to which I see a momentary flutter of disappointment cross her face. “Most medication reaches the baby in ten minutes.” At a lactation conference put on by the Breastfeeding Coalition of Placer County, Marsha Walker, RN, IBCLC says Fentanyl, a common pain medication used in labor, lasts about 2 hours in the mother and can last up to 13 hours in a baby. Babies should not be breastfed for 4 hours after administration. Often times mothers will receive more than one shot, that stacks up and may take a day or more for it to wear off in the baby.

A big grin spreads wide on Olivia’s face and she giggles as she says, “Okay, I changed my mind, I don’t think I want a baby after all.” Needing reassurance and more information, I assure her that in her childbirth preparation class she will learn all the necessary skills for coping with contractions without pain medication.

Wanting to give birth to a strong healthy baby is a big motivator to stay away from procedures that can affect the baby’s outcome. Many women want to try to give birth naturally, but then situations change, things come up and it becomes necessary. So it’s important to know what we’re working with. Information is power – here it is:

Labor medications can cause the baby to have trouble latching onto the breast, or sometimes they can’t sustain sucking.  In other words, they may open their mouth, latch on and then just fall asleep again. Sometimes it’s even hard to get them to wake up at all to feed. I hear lots of moms say their baby is ‘so good because he just sleeps’.  Sleeping is good, but we also need babies to eat.  In order to keep the baby’s blood sugar and calories up, avoid formula supplementation, and possibly separation from his mom and dad.  We like babies to nurse within the first hour of birth. After that, they may sleep for a long time and that’s okay for the first 24 hours, but after that, if a baby is sleeping and not eating 10-12 times in a 24 hour period, something’s going on that needs attention.

If you’ve given birth already, or have done it without pain medication, you know that the moment the baby is born is powerful and even majestic!  Pain medications can dull this response in both the baby and the mother. In fact, it reduces oxytocin, which is the hormone responsible for bonding.  It also reduces the letdown reflex, or in simpler terms, the ability for your milk to come into your breasts.  Alas, I do have a suggestion to get you, your baby and breastfeeding off to an excellent start:

  1. Take a prenatal breastfeeding class
  2. Make a breastfeeding plan
  3. Establish a relationship with a lactation specialist before you give birth, so you can call her for help.
  4. Hire a doula if possible, she is trained in non-pain medication comfort measures
  5. Take a childbirth class to learn more.

Whether or not laboring women end up needing pain medication during labor and birth, knowing what to look for when it comes to breastfeeding can be very useful. And, the reality is that most breastfeeding ‘problems’ or ‘situations’ can be corrected quickly with specialized help right from the start.

Laurie Chamberlin CD, ICCE, CLE owner of Chamberlin Childbirth teaches childbirth preparation classes and FREE prenatal breastfeeding classes.