In the UK, mothers are offered an injection after they have given birth to help them deliver the placenta. This is given because it speeds up delivery of the placenta and reduces blood loss. However, previous research has shown that women who receive this injection are less likely to be breastfeeding 48 hours after birth than those who do not have it [1]. This new study explored why this might happen.

The study looked at 288 mothers with a baby aged 0 – 6 months old and showed that although there was no difference in the number who started breastfeeding when their baby was born, those who had the injection were less likely to be breastfeeding by the time their baby was two weeks old.

The research then went on to examine the reasons why mothers started breastfeeding but stopped when their baby was very young. It showed that mothers who received this injection were more likely to report that they had a lot of pain breastfeeding or found that the baby had difficulties breastfeeding compared to those who did not have the injection. 

Dr Amy Brown, Programme Director for the MSc Child Public Health from Swansea University’s College of Human and Health Sciences said: “The findings are very interesting as they add to the growing evidence that medications that mothers receive during labour and birth might make breastfeeding more difficult and explain why, as the number of complicated births rises in the UK, breastfeeding rates have dropped. We knew previously that women who receive this injection were less likely to breastfeed but were unsure why this might happen. This data tells us why: women are more likely to experience pain and difficulty breastfeeding their baby which leads to them moving to formula milk.”

Dr Sue Jordan, Reader in the Department of Nursing explained:  “The injection may interfere with normal physiological processes that happen after childbirth. Breastfeeding depends on hormones known as oxytocin and prolactin. The injection might reduce the body’s natural responses to these hormones, making breastfeeding more difficult. The baby may not be able to feed effectively and milk supply might be decreased. This can lead to the problems the women in our study described: pain, difficulty getting their baby to feed, and their baby not gaining weight. These issues lead to women deciding to stop breastfeeding.”

Dr Brown said: “We know that breastfeeding is important for the health of both babies and mothers but also that many different factors, not always in the mother’s control, can affect it. Understanding the impact of medications received during childbirth is important for those working to support new mothers during this time. If we know that this injection increases risk of breastfeeding difficulties, but also that it is important for particular groups of mothers to receive it, we shall know to direct further support to these women to improve their experience of breastfeeding.”

Dr Jordan said: “UK guidelines do recommend that women receive this injection after they have given birth to shorten the time it takes to deliver the placenta and reduce blood loss. However, the guidelines also indicate that women at low risk of bleeding should be supported if they opt not to have the injection. Further research is needed to explore the best options for new mothers to understand the balance between protecting women from excessive blood loss and giving them the strongest chance of breastfeeding their baby.”

The research can be seen here http://www.ncbi.nlm.nih.gov/pubmed/25347567

1. Jordan S, Emery S, Watkins A, Evans J, Storey M, Morgan G. Associations of drugs routinely given in labour with breastfeeding at 48 hours: analysis of the Cardiff Births Survey. BJOG 2009; 116(12) 1622-30 DOI: 10.1111/j.1471-0528.2009.02256.x.