Abstract：Objective To explore the effect of epidural labor analgesia on neonatal lactation behavior and breastfeeding, and to provide data support for optimizing the prescription of epidural analgesics. Methods A total of 80 cases of parturient women who delivered naturally in Weifang Maternal and Child Health Hospital of Shandong Province from August 2020 to March 2021 were selected as the research objects. According to maternal wishes, they were divided into two groups, with 40 cases in each group. The experimental group received epidural analgesia, while the control group did not. The time of expression of lactation behavior and action was observed in the two groups, and the start time of lactation, the lactation initiation rate within 72 h and the times of exclusive breastfeeding 24 and 48 hours after delivery were compared between the two groups. Results The duration of neonate’s first cry in experimental group was shorter than that in control group, and it took longer to reach crawing, familiarity, and sucking stage than that in cotrol group (P ＜ 0.05); there were no significant differences in relaxation duration, awakening, activity, and sleep stage between two groups (P > 0.05). The start time of lactation in experimental group was earlier than that in control group (P < 0.05); there was no significant difference in the lactation initiation rate within 72 h between two groups (P > 0.05). There was no significant difference in the times of exclusive breastfeeding 24 and 48 hours after delivery between two groups (P > 0.05). Conclusion Labor analgesia may affect the expression of neonatal lactation behavior, which requires further optimization of analgesic drug prescription to minimize maternal and infant effects.
[1] Guasch E，Brogly N，Gilsanz F. Combined spinal epidural for labour analgesia and caesarean section：indications and recommendations [J]. Curr Opin Anaesthesiol，2020， 33（3）：284-290.
[2] Ransj?觟-Arvidson AB，Matthiesen AS，Lilja G，et al. Maternal Analgesia During Labor Disturbs Newborn Behavior：Effects on Breastfeeding，Temperature，and Crying[J]. Birth，2001，28（1）：5-12.
[3] 中华医学会围产医学分会，中华医学会妇产科学分会产科学组，中华护理学会产科护理专业委员会，等.中国新生儿早期基本保健技术专家共识（2020）[J].中华围产医学杂志，2020，23（7）：433-440.
[4] Widstr?觟m AM，Brimdyr K，Svensson K，et al. Skin-to-skin contact the first hour after birth，underlying implications and clinical practice[J]. Acta Paediatr，2019，108（7）：1192-1204.
[5] Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries：a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality[J]. Lancet，2000，355（9202）：451-455.
[6] Chapman DJ，Perez-Escamilla R. Maternal perception of the onset of lactation is a valid，public health indicator of lactogenesis stage Ⅱ [J]. J Nutr，2000，130（12）：2972-2980.
[7] Bornstein MH. Sensitive periods in development：structural characteristics and causal interpretations [J]. Psychol Bull，1989，105（2）：179-197.
[8] Feldman R，Rosenthal Z，Eidelman AI. Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life [J]. Biol Psychiatry，2014，75（1）：56-64.
[9] Brimdyr K，Cadwell K，Widstrom AM，et al. The effect of labor medications on normal newborn behavior in the first hour after birth：A prospective cohort study [J]. Early Hum Dev，2019，132：30-36.
[10] 庞艳，林芳初，李嫒，等.新生儿乳房爬行运动的研究进展[J].护理研究，2020，34（13）：2347-2350.
[11] 樊雪梅，余苹，姚渝沁，等.新生儿乳房爬行运动对早期母乳喂养的影响[J].护理学杂志，2021，36（17）：25-29.
[12] Smith LJ. Impact of birthing practices on the breastfeeding dyad[J]. J Midwifery Womens Health，2007，52（6）：621-630.
[13] Brimdyr K，Cadwell K，Widstrom AM，et al. The Association Between Common Labor Drugs and Suckling When Skin-to-Skin During the First Hour After Birth [J]. Birth，2015，42（4）：319-328.
[14] 李远志，王浩.腰麻剖宫产时盐酸罗哌卡因的胎盘转移[J].黑龙江医药，2017，30（2）：340-342.
[15] 姚向国，贾俊香，张运宏，等.不同浓度罗哌卡因腰麻剖宫产胎儿娩出时母体和胎儿脐血浓度的观察[J].临床麻醉学杂志，2012，28（1）：60-62.
[16] 王爱忠，江伟，徐惠芳.罗哌卡因经离体人胎盘单绒毛叶的转运及其影响因素[J].中华麻醉学杂志，2004，24（7）：45-47.
[17] 张新.剖宫产术患者应用舒芬太尼胎盘透过的观察及对新生儿的影响[D].唐山：华北理工大学，2018.
[18] 叶宁，许勤.持续硬膜外阻滞麻醉镇痛分娩对胎儿和新生儿的影响[J].齐鲁护理杂志，2012，18（26）：4-5.
[19] Froh EB，Lee R，Spatz DL. The Critical Window of Opportunity：Lactation Initiation Following Cesarean Birth[J]. Breastfeed Med，2021，16（3）：258-263.
[20] 潘东军，李春晖，王宏宇，等.全产程分娩镇痛对产妇泌乳素的影响[J].临床麻醉学杂志，2015，31（3）：264-266.
[21] 王玉双.罗哌卡因自控微量泵分娩镇痛对产程及分娩结局的影响[J].中国妇幼保健，2012，27（2）：290-292.
[22] 贾丽英，刘吉平，叶玉萍，等.腰麻-硬膜外联合麻醉分娩镇痛对产妇泌乳的影响[J].护理学杂志，2006，21（16）：9-10.
[23] 芦建懿，罗云梅，曹娟.硬膜外神经阻滞无痛分娩对母婴结局产妇泌乳功能及肠蠕动的影响[J].中国妇幼保健，2021，36（2）：309-311.
[24] Amiel-Tison C，Barrier G，Shnider SM，et al. A new neurologic and adaptive capacity scoring system for evaluating obstetric medications in full-term newborns [J]. Anesthesiology，1982，56（5）：340-350.
[25] 卢银军.0.1%罗哌卡因复合舒芬太尼硬膜外分娩镇痛对产妇产程疼痛程度及母婴结局的影响[J].中国妇幼保健，2021，36（1）：62-65.
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