Work improves public and professional awareness of the need to restrict the doses of medicines in labour
The benefits of breastfeeding to both infants and mothers underpin World Health Organisation and UK government policies. Swansea University researchers were the first to identify the importance of reducing doses of epidural pain relief and other medicines to facilitate breastfeeding. The findings indicated an association between medicines administered and breastfeeding rates: reductions of up to 40% were reported. This work improved public and professional awareness of the need to restrict the doses of medicines in labour, and enabled midwives to better identify mothers in the greatest need of breastfeeding support. Citing our work on the association between the dose of fentanyl and breastfeeding, seven guidelines for clinical practice now recommend restrictions on epidural fentanyl doses, as do the clinical protocols of the US Academy of Breastfeeding Medicine. Subsequently, doses were reduced and an increase in breastfeeding initiation rates followed 2005/6-2010/11 (66.2-73.7%).
Before 2005, high fentanyl doses affected 3-4% of the 750,000 infants born each year in the UK. A 2% increase in breastfeeding rates reduces UK infant hospital admissions for diarrhoea and lower respiratory infections by 2% and 1%; longer term benefits include decreased childhood obesity, diabetes and maternal breast cancer, and reduced NHS costs.