Jennifer Lind, PharmD, MPH is an Epidemic Intelligence Service Officer assigned to the Nutrition Branch in the Division of Nutrition, Physical Activity and Obesity at the CDC. Dr. Lind’s research is focused on research and surveillance issues related to infant and young child feeding practices. Before joining the CDC, Dr. Lind worked as a community pharmacist which led to her deep commitment to public health and fostered her interest in chronic diseases. Dr. Lind and her colleagues recently published a ground breaking study in the Journal of Human Lactation that demonstrates an association between use of labor pain medications and a delay in the onset of lactation (DOL) (defined as milk coming in >3 days after delivery).

Dr. Lind was recently interviewed by Marie Hemming, IBCLC, a member of the International Lactation Consultant Association® (ILCA®) Medialert Team.

Marie Hemming: What led you to study the effect of labor medications on the onset of lactation?

Dr. Lind: As a pharmacist, labor pain medications are of interest to me and there is very little research done on the association between labor medications and how it can potentially affect the onset of lactation. So many women (estimate of 83%) use labor pain medications and we know that a delay in the onset of lactation (DOL) can lead to shorter breastfeeding durations.

MH: Please summarize the results.

DL: Mainly, in all of the groups of labor pain medications and delivery method, we found that mothers who received labor pain medications were 2-3 times more likely to report DOL compared to mothers who did not use labor pain medications and delivered vaginally.

MH: Are there other studies that demonstrate this association?

DL: This information is relatively new. There are 2 other studies, but they are greater than 10 years old. This current study is the most recent data on the topic.

MH: What do you think are the public health implications of these study results?

DL: This research adds to the body of literature on the topic, which can help inform clinicians and women as they make decisions regarding labor and delivery.

More studies need to be done looking at this association to evaluate why this association exists.

Finally, we need to explore if by providing additional lactation support to women who receive labor pain medications, we are able to improve breastfeeding outcomes and prevent the shorter breastfeeding duration that we know exists in women who have DOL.

MH: How can these data be used by pregnant women?

DL: Women can use these data when they are talking to their health care providers about labor pain medications as part of the decision making process. The research can help them make an informed decision with the knowledge that there may be a risk of experiencing breastfeeding difficulties if they use labor pain medications. Women can also be prepared with appropriate community support mechanisms in case they do experience a delay in the onset of lactation after they are discharged from the hospital. Everyone is very excited about the information because it addresses a gap in this field which is great for clinicians who work in labor and delivery and help mothers enhance natural breast feeding.

MH: Studies show it can take up to 17 years to translate research into practice. How do you think we can disseminate this information more quickly to pregnant women and their caregivers?

DL: This study is available online at the Journal of Human Lactation now. We hope to reach as many families and clinicians as possible so that this can go into the clinical decision making process that mothers and their caregivers make.