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What Labor Practices Can Impact Breastfeeding Success?

Mom breastfeeding newborn infant in hospital.

So many times, I hear people say, “Well, breastfeeding is normal, right? Aren’t babies like little puppies? They should just instinctively know what to do, right?” Well, yes, but puppies aren’t born in hospitals. So, unlike baby humans, they aren’t subjected to labor practices that can impact breastfeeding success.

I cannot begin to estimate how many hundreds of families I’ve helped through the laboring, birthing, and breastfeeding process. But I can tell you, with certainty, I’ve observed four main categories of practices that I’ve observed as counterproductive to the breastfeeding process.

Practices that restrict the mother’s ability to be in control of her own body or her own decision-making

The first, and probably most obvious labor practice that can impact breastfeeding is limiting a mother’s movements. Restricting mothers to a bed or to a horizontal position has been repeatedly associated with assistive or operative births. I know this from having read dozens of studies, as well as seeing it in clinical practice many, many times.

In turn, operative interventions lead to all of the practical problems associated with breastfeeding in the early days. I would urge mothers to consider walking, dancing in labor/birth, and using waterbirth as much as possible.

Practices that alter hormonal function

Studies suggest that there is some relationship between synthetic oxytocin inductions and decreased breastfeeding initiation and continuation.

And, an astounding cohort study by Marín  Gabriel and colleagues showed that primitive reflexes (e.g., rooting, etc.) were diminished in infants whose mothers had had a Pitocin™ induction. These hormone-altering labor practices that can impact breastfeeding success.

Also, contractions that are induced or augmented with a synthetic oxytocin are usually much more forceful than those that occur naturally. Mothers become exhausted.

For many, the pain is so bad that they ask for an epidural infusion, even if they had planned to have an unmedicated birth.

Practices that involve medicated labors

Like me, you may have stacks and stacks of research studies in your file cabinet. (Yes, I still print them out!)

You have one big stack concluding that epidural infusions during labor don’t affect breastfeeding in the postpartum period. The other stack draws the opposite conclusion.

First, we can’t confuse epidural anesthesia (loss of neural as well as sensory control) with epidural analgesia (only sensory control.)

Therefore, when we say “epidurals” we need to know what we’re talking about here. And, was the epidural infusion started a few minutes ago, or several hours ago? What were the medications in the epidural infusion?

I think there is general agreement that analgesics given in in labor cross the blood brain barrier. Hence, I think it’s difficult, if not impossible, to avoid having some negative effects on the fetus.

AND there’s more.

In many or most cases, epidural analgesia results in poor pushing efforts. That’s a set-up for an assistive or operative birth. Donning my flak jacket, I’m going to suggest hypnosis as one possible alternative to this labor practice that can impact breastfeeding.

Practices that associated with increased likelihood of intervention

By “intervention” I mean anything that is invasive.

Any practices that are associated with birth trauma or injury can impact breastfeeding. For example, an amniotomy eliminates the “cushion” for the fetal skull. That is then associated with caput succedaneum, possibly cephalhematoma, and more. Dr. Andrew Dorough had more to say on this as related to plagiocephaly.

But let’s say he’s wrong. I would argue that, at the very least, these kids have a headache. Does a headache affect your behavior? I believe that pain is a likely explanation for these “reluctant nurser” stories. I address this birth trauma question much deeper in my Guide to Decoding Lactation Photos Course.

I’ve seen how breastfeeding can be impacted by an amniotomy or a fetal scalp electrode, or even an IV in the mother’s arm. It’s a long list.  

Final thoughts on labor practices that can impact breastfeeding success

I’ve given just a few examples here.

My passion for labor/delivery issues has not faded in more than 40 years. I truly believe that until we can normalize the labor/birth processes, we will have a tough time increasing breastfeeding initiation and continuation.

Have you seen examples of how labor practices can impact breastfeeding? Share your thoughts in the comments below.

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