WOMEN who give birth with the aid of pain-relieving epidurals find it harder to breast-feed than those who give birth naturally, a study has found.

The research suggests that some of the drugs used in epidurals make their way into babies’ bloodstreams, subtly affecting their brains and development for weeks afterwards — including making them less willing to breast-feed.

If confirmed, such research could force a rethink over the use of the drugs.

Up to a third of British women giving birth are routinely given epidurals in which a catheter is inserted into the spine to allow the infusion of pain-killing drugs. These deaden the nerves that relay sensations of pain from the lower body and legs.

In a commentary on the research, published today, one expert suggests the impact of epidurals on breast-feeding should be officially classed as an “adverse drug reaction”.

Writing in International Breastfeeding Journal, Sue Jordan, senior lecturer in applied therapeutics at Swansea University, says women given the infusions should be offered extra support to stop their infants being “disadvantaged by this hidden, but far-reaching, adverse drug reaction”.

Such a link could help explain why many British women fail to breast-feed, with 55% giving up within six weeks of birth. More than a third of women give up within a week, saying their babies simply refuse to breast-feed.

In the research, published in the same journal, Siranda Torvaldsen, from Sydney University, and colleagues

from other institutions in Australia, studied 1,280 women who had given birth, of whom 416 had an epidural. The researchers found 93% of the women breast-fed their baby in the first week but those who received epidurals generally had more difficulty in the days immediately after birth.

By the time six months had passed, the women who had been given epidurals were twice as likely to have stopped breast-feeding, even after allowing for factors such as maternal age and education.

The authors suggest the most likely cause of the problem was fentanyl, an opioid drug widely used as a component of epidurals. Such drugs pass quickly into the bloodstream and easily cross the placenta to reach the unborn baby.

Many women have a good experience with epidurals because the drugs allow them to relax. However, researchers have long known that there are also potential adverse side effects such as lowered blood pressure, a slowing of the birth process and a greater risk of having to pull the baby out with forceps.

There has, however, been less research into the impact of such drugs on babies, although it is known that, because of their immature livers, the drugs can linger in the body.

Other researchers support Torvaldsen’s findings. A study at Toronto University, Canada, of 177 women found they were less likely to be breast-feeding after six weeks if they had been given an epidural with fentanyl.

Sunday Times