Many pregnant women worry about labor pain during childbirth. Pain levels can vary based on factors such as your birth environment, your baby’s position, and the intensity of your contractions. Understanding your pain management options before labor begins can help you feel confident in the choices you make about your care. Every mother and baby are different, so it’s important to have support that aligns with your birth and breastfeeding goals.

The way you give birth, medications used during labor, and your overall health can all influence early breastfeeding. While medical interventions can be necessary and lifesaving, they may also have a negative effect on breastfeeding—especially on the first day. Open communication with your birth team about your birth plan, medications, and feeding goals is essential for making informed decisions and ensuring the best possible start for both you and your baby.

What is an Epidural?

An epidural is a combination of narcotic pain medication and regional anesthesia administered through a catheter into the epidural space near the spine. After a small numbing injection, the epidural catheter is placed, allowing continuous pain relief during labor. You may feel a brief pinch or pressure as the catheter is inserted. How quickly and how long the pain relief lasts will depend on the dose, type, and concentration of medication used.

Benefits of Epidural Analgesia

  • Rapid pain relief, usually within 10–20 minutes

  • Can be requested at any point up until delivery

  • Allows you to rest and remain alert during childbirth

  • Useful for prolonged labor or if a cesarean delivery become necessary

  • Generally safe and effective pain relief

Potential Risks & Complications 

While generally considered safe, some possible side effects may include:

  • Weakened or slowed contractions 

  • Pushing that is more difficult 

  • Prolonged labor

  • Numbness for an extended period after delivery 

  • Difficulty urinating 

  • Fever or infection at the injection site

  • Headache or changes in blood pressure 

  • Respiratory issues for mother or baby

  • Low fetal heart rate 

Deciding whether to have an epidural is a personal decision. Discussing the effects of epidural analgesia with your doctor or anesthesiologist—including medication type, dosage, and timing—can help support both your birth experience and breastfeeding outcomes.

Epidurals and Breastfeeding

Epidurals may influence your baby’s early instinctive behaviors after birth. Research suggests that some babies whose mothers received epidurals may experience:

Baby-related challenges

  • Difficulty latching or sucking

  • Increased sleepiness during early feeding sessions

  • Less effective coordination of suck-swallow-breathe patterns

  • Lower initial feeding stamina, which can make longer or frequent feeds challenging

These early challenges can contribute to missed feeding opportunities, more excessive infant weight loss, and lower milk supply in the early postpartum period, which may affect long-term breastfeeding success.

Mother-related considerations

  • Increased fatigue or difficulty positioning for feeds due to numbness or limited mobility

  • Greater reliance on lactation support in the early postpartum period

  • Increased breast engorgement, often related to IV fluids given during labor

  • Greater risk of delayed onset of lactation, typically around 3–4 days postpartum

Some studies show a significant difference in breastfeeding outcomes between mothers who received epidural analgesia compared to those who did not. However, other risk factors such as additional birth interventions—like Pitocin (synthetic oxytocin) induction or augmentation—and prior breastfeeding experience also play an important role.

Protecting Your Breastfeeding Goals

Even if you choose an epidural during labor, successful breastfeeding is still possible. Consider the following strategies:

  • Learn breastfeeding basics through prenatal classes or a lactation consultation.

  • Include your feeding goals in your birth plan.

  • Prioritize lots of skin-to-skin contact. Healthy newborn infants should be placed immediately on their mother's chest for at least the first hour after birth.

  • Aim for frequent breastfeeding, at least 8–12 feeds per day, in the early weeks postpartum.

  • Offer your baby additional hand-expressed colostrum after feedings, to ensure they are getting plenty of breast milk and to avoid serious complications.

  • Plan for ongoing lactation support after leaving the hospital.

With the right support, nearly all mothers—including those who receive epidurals—can successfully breastfeed. By understanding potential challenges, you can set realistic expectations and navigate any obstacles with confidence, ensuring your baby receives the nourishment they need. After nine months of carrying your baby, breastfeeding is the next step in continuing that care—offering nourishment, connection, and comfort.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare provider and/or lactation consultant.