{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:07:51Z","timestamp":1789204071510,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:00:00Z","timestamp":1633651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Intrapartum opioids in labor may interfere with the early breastfeeding phase and cause breastfeeding difficulties. This study examines the effects of intrapartum fentanyl given intravenously (IV) or through epidural analgesia (EDA) on early breastfeeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a prospective observational study conducted in a regional maternity unit. We included 1101 healthy mothers of term singleton babies in vertex presentation born between 2016 and 2018 (468 nulliparous and 633 multiparous). The main data were collected prospectively, and additional data were retrieved from hospital records. The main outcome measures were exclusive breastfeeding at discharge, spontaneous suckling, and breastfeeding problems after birth. We assessed the outcomes in four groups categorized by intrapartum opioid exposure: none, IV fentanyl, EDA fentanyl and IV+EDA fentanyl. We also analyzed the dose\u2013response relation of fentanyl administered by epidural or IV and early breastfeeding. Ultimately, we dichotomized the IV fentanyl group into two groups (\u2264200\u00a0\u00b5g and &gt;200\u00a0\u00b5g) to further study the effect on early breastfeeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The odds of non\u2010exclusive breastfeeding were doubled with EDA fentanyl (odds ratio [OR] 2.45, 95% CI 1.34\u20134.48, <jats:italic>p\u00a0<\/jats:italic>=\u00a00.004) and four times higher with IV+EDA fentanyl (OR 4.20, 95% CI 2.49\u20137.09, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) compared with no opioid exposure. Spontaneous suckling was negatively associated with intrapartum fentanyl use (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) irrespective of mode of administration. When the IV fentanyl doses exceeded 200\u00a0\u00b5g compared with less than 200\u00a0\u00b5g, we found a reduction in exclusive breastfeeding (81% vs. 89%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.014) and spontaneous suckling (68% vs. 83%; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and an increase in breastfeeding problems (41% vs. 27%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fentanyl in labor is associated with breastfeeding difficulties. However, IV fentanyl in low doses (\u2264200\u00a0\u00b5g) seems to affect breastfeeding less than EDA fentanyl and is therefore a viable alternative when labor analgesia is needed. This could be most relevant for multiparous women, where a shorter labor is expected. More research is needed to determine the optimal dose and route of administration of fentanyl for labor analgesia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14268","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T06:22:16Z","timestamp":1633846936000},"page":"2294-2302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The association between intrapartum opioid fentanyl and early breastfeeding: A prospective observational study"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1810-9664","authenticated-orcid":false,"given":"Hanna","family":"Oommen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology S\u00f8rlandet Hospital Kristiansand Kristiansand Norway"},{"name":"Department of Life Science and Education University of South Wales Pontypridd UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor","family":"Oddbj\u00f8rn Tveit","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care S\u00f8rlandet Hospital Kristiansand Norway"},{"name":"Research Department S\u00f8rlandet Hospital Kristiansand Norway"},{"name":"Faculty of Health and Sport Science University of Agder Kristiansand Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif T.","family":"Eskedal","sequence":"additional","affiliation":[{"name":"Research Department S\u00f8rlandet Hospital Kristiansand Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Myr","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology S\u00f8rlandet Hospital Kristiansand Kristiansand Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Swanson","sequence":"additional","affiliation":[{"name":"Oslo Center for Biostatistics and Epidemiology Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5262-6326","authenticated-orcid":false,"given":"Ingvild","family":"Vistad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology S\u00f8rlandet Hospital Kristiansand Kristiansand Norway"},{"name":"Research Department S\u00f8rlandet Hospital Kristiansand Norway"},{"name":"Faculty of Health and Sport Science University of Agder Kristiansand Norway"},{"name":"Department of Clinical Science University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01024-7"},{"key":"e_1_2_11_3_1","first-page":"CD003519","article-title":"Early skin\u2010to\u2010skin contact for mothers and their healthy newborn infants","volume":"11","author":"Moore ER","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_4_1","first-page":"CD007396","article-title":"Parenteral opioids for maternal painmanagement in labour","volume":"6","author":"Smith LA","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12186"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2007.01.010"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2009.01988.x"},{"key":"e_1_2_11_8_1","unstructured":"Medical Birth Registry of Norway (MBRN). 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WHO recommendation on opioid analgesia for pain relief during labour. Geneva: World Health Organization; 2018. [cited December 6 2019]. Available from:https:\/\/extranet.who.int\/rhl\/guidelines\/who\u2010recommendations\u2010intrapartum\u2010care\u2010positive\u2010childbirth\u2010experience"},{"key":"e_1_2_11_26_1","volume-title":"WHO recommendation on epidural analgesia for pain relief during labour","author":"WHO Reproductive Health Library","year":"2018"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2012.09.003"},{"key":"e_1_2_11_28_1","volume-title":"WHO recommendation on maternal mobility and position during labor","author":"WHO Reproductive Health Library","year":"2018"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-2011.2012.00254.x"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.871255"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14268","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14268","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14268","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T04:25:00Z","timestamp":1693196700000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14268"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,8]]},"references-count":29,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/aogs.14268"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14268","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,8]]},"assertion":[{"value":"2020-10-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}