Relationship between use of labor pain medications and delayed onset of lactation

J Hum Lact. 2014 May;30(2):167-73. doi: 10.1177/0890334413520189. Epub 2014 Jan 22.


Background: Despite estimates that 83% of mothers in the United States receive labor pain medications, little research has been done on how use of these medications affect onset of lactation.

Objective: To investigate whether use of labor pain medications is associated with delayed onset of lactation (DOL).

Methods: We analyzed data from the 2005-2007 Infant Feeding Practices Study II, a longitudinal study of women from late pregnancy through the entire first year after birth (n = 2366). In multivariable logistic regression analyses, we assessed the relationship between mothers' use of labor pain medication/method and DOL (milk coming in > 3 days after delivery).

Results: Overall, 23.4% of women in our sample experienced DOL. Compared with women who delivered vaginally and received no labor pain medication, women who received labor pain medications had a higher odds of experiencing DOL: vaginal with spinal/epidural only (aOR 2.05; 95% CI, 1.43-2.95), vaginal with spinal/epidural plus another medication (aOR 1.79; 95% CI, 1.16-2.76), vaginal with other labor pain medications only ([not spinal/epidural]; aOR 1.84; 95% CI, 1.14-2.98), planned cesarean section with spinal/epidural only (aOR 2.13; 95% CI, 1.39-3.27), planned cesarean with spinal/epidural plus another medication (aOR 2.67; 95% CI, 1.35-5.29), emergency cesarean with spinal/epidural only (aOR 2.17; 95% CI, 1.34-3.51), and emergency cesarean with spinal/epidural plus another medication (aOR 3.03; 95% CI, 1.77-5.18).

Conclusion: Mothers who received labor pain medications were more likely to report DOL, regardless of delivery method. This information could help inform clinical decisions regarding labor/delivery.

Keywords: breastfeeding; labor and delivery; lactation; medication; risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Analgesia, Epidural / adverse effects
  • Analgesics / adverse effects*
  • Analgesics / therapeutic use
  • Breast Feeding*
  • Delivery, Obstetric / adverse effects*
  • Delivery, Obstetric / methods
  • Female
  • Humans
  • Labor Pain / complications
  • Labor Pain / therapy*
  • Lactation / drug effects*
  • Lactation / physiology
  • Pregnancy
  • Time Factors
  • United States


  • Analgesics