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WOMEN who take painkillers during childbirth could jeopardise their chances
of bonding with their baby. Swedish researchers have found that painkillers
prevent newborns from breastfeeding normally. This in turn may affect the levels
of a key maternal hormone that helps mother and baby bond shortly after
birth.

鈥淭hese results highlight the importance of reducing or eliminating the use of
these agents, especially in US hospitals, where epidural analgesia use during
labour has become almost routine,鈥� say John Kennell and Susan McGrath of the
Rainbow Babies and Children鈥檚 Hospital in Cleveland, Ohio.

Researchers know that analgesics taken during labour have adverse effects on
the mother, but their effects on the baby have not been well documented, says
Anna-Berit Ransj枚-Arvidson of the Karolinska Institute in Stockholm. In
earlier studies she and her colleagues found that newborns whose mothers took no
painkillers during labour instinctively move towards the mother鈥檚 breast,
massage it with their hands, reach for the nipple and start sucking about an
hour after birth. 鈥淲e wanted to see how interventions like analgesia affect a
newborn鈥檚 behaviour,鈥� says 搁补苍蝉箩枚-础谤惫颈诲蝉辞苍.

So her team videotaped 28 newborns, delivered vaginally, who were dried
immediately after birth and placed against their mother鈥檚 breasts. Eighteen
mothers had taken some form of painkiller鈥攊ncluding bupivacaine,
mepivacaine and pethidine, given either as epidurals, pudendal nerve blocks or
intramuscular injections.

Infants who were not exposed to painkillers behaved entirely normally. But
most infants exposed to analgesia did not massage the breast at all, or only
massaged it during one or two 15-minute periods. Nearly half of them did not
breastfeed within the first 2.5 hours after birth.

Ransj枚-Arvidson speculates that the painkillers are numbing the infants.
Pethidine and local anaesthetics readily pass across the placenta, and the other
painkillers may do the same, she says.

In women who took no painkillers, the team also found levels of the hormone
oxytocin鈥攚hich controls lactation and contraction of the
uterus鈥攊ncreased whenever the baby massaged or sucked their mother鈥檚
breast. In animals, researchers have shown that the hormone facilitates bonding
between the mother and baby
(New Scientist, 1 July 2000, p 12).
Since a baby exposed to analgesia interacts less with the mother, painkillers may damp
down the release of maternal oxytocin and stop mother and baby bonding readily, says
搁补苍蝉箩枚-础谤惫颈诲蝉辞苍.

Her team has already started studying this connection. 鈥淲e need to do more
studies, especially as there is a very high increase in [the use of] epidural
and other pain relievers,鈥� she says. But analgesics are big business and it
won鈥檛 be easy to convince hospitals to forgo painkillers, despite their
drawbacks. 鈥淭here鈥檚 a lot of money in epidurals,鈥� she says.