The Birth Experience And Its Effect on Breastfeeding

There are many situations that may affect the path that your breastfeeding plans may take. Your baby's ability to breastfeed may be affected by his birth experience. Suckling effectively, which is a key component to breastfeeding, is an important factor in the baby's growth and development. Here are some common interventions and issues that may affect proper behavior at the breast.

Epidural Anesthesia

Epidurals are a very hot topic in the birthing and breastfeeding world.

For many women, they can make or break the entire birth experience. As far as anesthesia during labor is concerned, it an epidural is preferred over narcotics because it does not enter the baby's circulation, which can cause central nervous system depression.

It is very difficult to state with certainty that there is an association between epidural anesthesia and negative newborn feeding behavior. Anecdotally, most women do not have problems breastfeeding their newborns after they have had an epidural for a short period of time. There are several studies that have been conducted to determine the effects and, happily for those who desire epidurals, few have shown any correlation to negative breastfeeding behaviors. There is some research that indicates altered newborn behavior, drowsiness, and disorganized suckling after epidural anesthesia, but the jury is still out on whether or not the epidurals were truly to blame in these studies.

Talk to your doctor prior to going into labor to make an informed decision about what is best for you.


Different than epidural anesthesia, narcotics do pass through the placenta and enter the fetal circulation. This may cause central nervous system depression, and, as a result, the baby may have a more difficult time latching on.

In these cases, your baby will be observed for drowsiness, negative feeding behaviors and weight loss.

Premature and Low Birth Weight Babies

When a baby is born before her proper time, or if her birth weight is less than 5 pounds, 8 ounces, her health is considered high-risk, and the stress placed on the family can be overwhelming. A mother who has had grand plans to breastfeed may feel disappointed that her situation is not ideally suited for such a task. Because of this, there are very low breastfeeding rates for premature and low birth weight infants; studies have shown that the shorter the gestational period of the baby, the shorter the length of breastfeeding. However, most mothers of premature babies who decide to breastfeed do so because of the health benefits of breastmilk for their at-risk babies, rather than a simple desire to nurse.

Neonatal Intensive Care Unit (NICU)

Whether a newborn is premature or is full-term but needs to be monitored for a particular health issue, being sent to the NICU can have an impact on breastfeeding.

Unfortunately, hospital practices have been shown to be the major obstacle to breastfeeding success of NICU babies. The Baby-Friendly Hospital Initiative encourages that every baby, including those in the NICU, be regarded as possible breastfeeders. If you do have a baby that is in the NICU, and you're unsure about how you plan to feed, it is recommended that you begin to pump to stimulate your milk supply in case you decide you will breastfeed. It's much easier to build a supply soon after birth because your body is expecting to do so. Trying to stimulate your milk supply later can be more difficult. You can always choose to stop.

Here is the "4 Phase Model" for breastfeeding in the NICU:

  1. Expression and collection of breast milk
  2. Gavage feeding of expressed breast milk
  3. In-hospital lactation consultations
  4. Post-discharge hospital consultations

Cesarean Deliveries

Unfortunately in the United States, c-sections have been connected with the decreased likelihood that a mother will breastfeed. Both physical and psychological issues after a Cesarean can have an impact on the decision to breastfeed. Physically, a mom may be very uncomfortable and have a lot of pain -- the mere thought of putting the baby anywhere near her abdomen can turn her off to the process. Psychologically, she may not have expected her delivery to go this way (especially if she had an emergency c-section and had idealized a natural delivery). She might feel disappointed in the whole process.

The type of anesthesia the mother received during delivery may also impact the ability to feed. However, despite all of these facts, many women battle the statistics by taking a prenatal breastfeeding class or reading books and becoming well-informed about breastfeeding prior to delivery.

Whether you have a scheduled c-section or end up with an emergency delivery, read up on breastfeeding after a Cesarean so you can feel prepared.

If your birth experience was less than optimal, it is important that you contact a lactation consultant so you can receive proper lactation education and support.


Chang ZM, RN, MN, IBCLC, and Heaman MI, RN, PhD. "Epidural Analgesia During Labor and Delivery: Effects on the Initiation and Continuation of Effective Breastfeeding." Journal of Human Lactation 2005 21:305-314.

Meier PP. "Breastfeeding in the Special Care Nursery: Prematures and Infants with Medical Problems." Pediatr Clin North Am. 48(2):425-442, 2001.

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