Drugs given during labour linked to breastfeeding problems

Drugs and painkillers that are routinely given to women in labour may reduce their ability to breastfeed their baby, reseachers say.

A study seen by The Times ahead of its publication today, suggests that life-saving medication given to nearly all women to prevent and treat bleeding after birth is linked to reduced breastfeeding rates.

The findings indicate a potential biological reason for why so many women in Britain fail to breastfeed, despite government efforts to increase the number of infants receiving their mother’s milk.

The Department of Health recommends that all children are breastfed for the first six months, because of the health benefits it can provide for both mother and baby. But breastfeeding rates in Britain are among the lowest in Europe, with only 45 per cent of infants exclusively breastfed a week after birth, and one in four receiving only formula milk from birth.

Analysis of the records of more than 48,000 women who gave birth in South Wales found that use of the clotting agents oxytocin or ergometrine was associated with a 7 per cent decline in the proportion who started breastfeeding within 48 hours of giving birth.

It is thought that the drugs may impede a woman’s ability to produce milk, suggesting that mothers who have them may need greater time or support from midwives if they wish to breastfeed their baby.

The study, by researchers at Swansea University, also confirmed the link between high doses of injected pain relief and lower rates of breastfeeding, an association that has recently prompted revised guidelines for the NHS on the use of epidurals in labour.

Sue Jordan, who led the study, said that the Government’s target to increase breastfeeding rates by 2 per cent a year was “unlikely to be met” unless further research was carried out. Young mothers or those discouraged from breastfeeding for social or cultural reasons are more likely to feed their babies from a bottle, but the main reasons cited for failure to breastfeed are a lack of milk or babies that simply refuse to feed.

Of the women involved in the study, who all gave birth between 1989 and 1999, two thirds (65.5 per cent) of those who did not receive drugs to prevent post-partum haemorrhage started breastfeeding their baby within 48 hours of giving birth.

But the proportion of those doing so reduced to 59.1 per cent among those given an injection of oxytocin, a hormone that plays an important natural role in labour, and to 56.4 per cent of women given an additional injection of ergometrine, given to address actual bleeding.

Overall, nearly eight out of ten (79 per cent) of the women in the study received either oxytocin, ergometrine or both. It is routine for women being treated on the NHS to be offered these drugs. The decline of 6-7 per cent in those being breastfed could lead to up to 50,000 fewer British babies being breastfed every year than might otherwise be possible, she added.

Because of the health benefits of breastfeeding, 50,000 bottle-fed infants represents the possibility of about 1,000 children becoming clinically obese, or 3,000 additional cases of childhood asthma. It could also greatly increase the number of mothers affected by breast cancer.

The findings are published today in BJOG: An International Journal of Obstetrics and Gynaecology.

Dr Jordan said: “The potentially life-saving treatments to prevent bleeding after birth must not be compromised on the basis of this study but further studies are required to establish ways to minimise any effects on breastfeeding rates."

Rosemary Dodds, policy research officer for the National Childbirth Trust, said: “Women need more support to start breastfeeding soon after giving birth and this study adds weight to that.

“A lot of women are not given enough information about the medications that might be given to them during childbirth, and women at low risk of bleeding may not need to take these drugs.

“It is important that women understand the risks and can give their informed consent before they go into labour.”