Pain Control and Breast-feeding

Most mothers-to-be plan to breast-feed their babies. While there are many different factors involved in successful breast-feeding, one factor that is not usually even considered is the pain that a mother may experience after delivery. In fact, if the pain is severe, it can be a very important factor in whether breast-feeding is successful or not.

* The pain of childbirth doesn’t end at the moment of delivery.
Pain is common after both vaginal and caesarean delivery. After vaginal delivery, the pain is most severe in the tissues of the vagina and the perineum. For women who have had episiotomies or tears, the pain is even worse. After a caesarean, the pain is felt mainly in the abdomen, at the incision.

* Whether you have a vaginal or caesarean delivery, the uterus continues to contract after your baby is born, and breast-feeding actually increases that pain.
The contractions that return your uterus to its non-pregnant state hurt. And these contractions (called “after-pains”) are intensified by breast-feeding, an act that causes the release of oxytocin–the body’s natural pitocin–from your pituitary gland. So breast-feeding itself causes you more pain. And the pain that occurs during breast-feeding gets worse with each subsequent baby you have. Women that have many children say that the after-pains can hurt even more than labor.

* When humans experience pain, they aren’t at their best to interact with others, which makes it more difficult to nurse.
Most people suffering from pain would just like to curl up in bed and not deal with anything else. But if you’re a new mom, there’s a newborn counting on you to take care of it. If you have people to help you, for example, the nurse at the hospital, and they can give your baby a bottle, that’s fine. But if you want to breast-feed, you’ll be better able to focus on it if you’re not in pain.

* Any pain medication the mother takes gets into the breast milk and reaches the baby; if it’s medication that makes the mom drowsy, it will also make the baby sleepy.
A post delivery epidural will relieve much of the pain–and without the harm to the baby that other pain medications will cause. That’s because with a pre or post delivery epidural, unlike with oral or intravenous medication, only a very small amount is required to relieve the pain, because it is administered right next to the nerves that carry the pain signals.

Successful breast-feeding depends on many different factors. Post-delivery pain experienced by the mother is one factor seldom considered — but it should be. Controlling the pain may help to improve the chance of breast-feeding success. And the best way to control pain is with a post delivery epidural. Find out if the hospital where you will be having your baby gives you the option of receiving post delivery epidural medications after you deliver.

Gilbert J. Grant, MD, an obstetric anesthesiologist in New York City, is author of Epidural Without Guilt:Childbirth Without Pain.