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据澳大利亚悉尼大学医学院高级研究员Siranda Torvaldsen博士领衔的一项新的研究结果表明，应用硬膜外麻醉和其它止痛药物以减轻分娩痛苦与母乳喂养率降低有关。该研究结果发表在《国际母乳喂养杂志》。

研究人员对在1997年生产的1280名澳大利亚母亲进行了随访研究。分娩时采用硬膜外麻醉的母亲与未采用硬膜外麻醉的母亲相比，往往在产后的第一周内容易出现母乳喂养困难，她们也更多的在产后的6个月内终止母乳喂养。

参加该项研究的1280名妇女中，416名（33%）妇女分娩时应用硬膜外麻醉，其中172名（41%）妇女行剖宫产术。

Torvaldsen博士称，“尽管大多数（93%）产妇在产后第一周内开始母乳喂养她们的宝宝，然而硬膜外麻醉与产后前几天、以及部分前一周内母乳喂养困难具有显著的相关性。

考虑到母亲的年龄和受教育程度因素，研究人员发现，应用硬膜外麻醉的妇女在产后6 个月内停止母乳喂养的人数是未应用者的两倍。

Torvaldsen博士及其同事发现，72%的分娩时没有使用止痛药的妇女在产后24周仍母乳喂养，相比之下，使用哌替啶（pethidine）或硬膜外麻醉应用布比卡因（bupivacaine）和芬太尼（fentanyl）的妇女仅为53%。

英国斯旺西大学健康科学学院的Sue Jordan博士曾于去年从事分娩及哺乳期间应用芬太尼的研究，她在同期的《国际母乳喂养杂志》上评论“目前证据”时说，包括这项最新的研究在内，没有一项研究最后证实分娩期间应用止痛药物直接导致母乳喂养减少。

为什么分娩时应用止痛药物的母亲产后早期没有母乳喂养宝宝或过早停止母乳喂养，这或许另有原因。然而，Jordan博士说“产妇及其临床医生可能认为已经有足够的证据证明，对于在分娩时应用大剂量的止痛药物的产妇实施母乳喂养给予更多的鼓励是正确的。”

If You Take Painkillers During Childbirth, You May Have Difficulty Breastfeeding

Main Category: Women's Health / OBGYN News
Article Date: 12 Dec 2006 - 5:00am (PST)

Epidurals and other painkillers used to ease childbirth are linked with decreased rates of breastfeeding. This is the result of a new study led by Dr Siranda Torvaldsen, a senior researcher in the Facultly of Medicine at the University of Sydney, Australia.

The study is published in the International Breastfeeding Journal.

The research followed 1280 Australian mothers who gave birth in 1997. Mothers who had epidurals during labour were more likely to have problems breastfeeding during the first week afterwards than mothers who did not have epidurals. They were also more likely to stop breasfeeding in the first six months.

Of the 1280 women in the study, 416 (33 per cent) had an epidural during childbirth, of whom 172 (41 per cent) also underwent cesarean section.

According to Dr Torvaldsen, "although most (93 per cent) women breastfed their baby in the first week, epidural anesthesia was significantly associated with difficulty breastfeeding in the first few days after birth, and with partial breastfeeding in the first week after delivery."

After taking the mother's age and education into account, the researchers found that stopping breastfeeding during the six months following childbirth was twice as likely for women who used epidurals compared to those that did not.

Dr Torvaldsen and her colleagues found that 72 per cent of the women who had given birth without painkillers were still breastfeeding 24 weeks later, compared to 53 per cent of the women who took pethidine or had an epidural containing bupivacaine and fentanyl.

Dr Sue Jordan, of the School of Health Sciences at Swansea University in the UK, researched the use of fentanyl during labour and breastfeeding last year, and comments on "the evidence so far" in the same issue of International Breastfeeding Journal. She says no research, including this latest study, has proved conclusively that using painkillers during labour directly causes less breastfeeding.

There may be other reasons why mothers who have painkillers during labour tend not to breastfeed or stop breastfeeding early. However, Dr Jordan suggests that "women and their clinicians may feel that sufficient evidence has accumulated to justify offering extra support to establish breastfeeding if women have received high doses of analgesics in labour."

http://www.medicalnewstoday.com/healthnews.php?newsid=58772

编辑：蓝色幻想