Labor epidural analgesia may be associated with reduced likelihood of breastfeeding at 6 weeks, according to a study published in Anesthesia & Analgesia.

The study included women intending to breastfeed who had delivered vaginally with or without labor epidural analgesia (n=1204). The researchers recorded breastfeeding at 3 days and 6 weeks postpartum. The primary outcome was breastfeeding at 6 weeks.

Overall, 76.9% of participants were breastfeeding at 6 weeks. The rate of breastfeeding was significantly lower for women delivering with vs without labor epidural analgesia (74.0% vs 83.4%, respectively; P <.001). Women with more than 1 child (n=806) were found to be more likely to breastfeed at 6 weeks compared with women who had just 1 child (n=398; 80.0% vs 70.6%, respectively; P <.001).

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Using a modified multivariable logistic regression in which parity was replaced with previous breastfeeding experience, the researchers found that only previous breastfeeding experience was associated with increased likelihood of breastfeeding at 6 weeks (odds ratio, 3.17; 95% CI, 1.72-5.80; P <.001).

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“[B]ecause previous breastfeeding experience was associated with higher likelihood of successful breastfeeding, our findings taken together suggest that other psychophysical factors predisposing women to request [labor epidural analgesia] also affect breastfeeding outcomes,” concluded the study authors.

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Orbach-Zinger S, Landau R, Davis A, et al. The effect of labor epidural analgesia on breastfeeding outcomes: a prospective observational cohort study in a mixed-parity cohort. [published online May 25, 2018]. Anesth Analg. doi: 10.1213/ANE.0000000000003442