Epidural Labor Analgesia: Fentanyl Dose and Breastfeeding Success A Randomized Clinical Trial

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(Anesthesiology 2017;127:614–624)Breastfeeding incurs substantial long-term and short-term health benefits to the infant and mother and is also an important public health concern. Prior studies provided conflicting results regarding the effects of neuraxial analgesia for labor, particularly with fentanyl, on postpartum breastfeeding. This double-blind, randomized controlled clinical trial aimed to evaluate the impact of intrapartum epidural fentanyl on breastfeeding success in the initial postpartum period, as well as at 6 weeks and 3 months postpartum. Self-reported breastfeeding at 6 weeks postpartum was the primary outcome of this study, whereas 1-minute Apgar scores <7, day-1 LATCH (Latch, Audible swallowing, Type of nipple, Comfort, and Hold/help) breastfeeding assessments, the rate of mothers who discontinued breastfeeding at 3 months, and the reasons stated for discontinuation of breastfeeding were the secondary outcomes.

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