Césarienne, allaitement et douleur

Caesarean section negatively impacts breastfeeding. Postoperative pain can be an explanation. Acute postoperative pain leads to persistent pain and depression. Postoperative pain control is therefore critical after C-section. A multimodal approach that is currently the “state of the art” relies on a combination of analgesic agents: acetaminophen, non-steroidal anti-inflammatory drugs (NSAID) and opioids. All analgesic drugs can be used during breastfeeding despite milk transfer: neonatal acetaminophen concentrations are low, NSAID are highly bound to proteins and poorly transferred into breast milk. Codeine and other opioid agents that undergo CYP2D6 metabolism could lead to serious adverse effects in both mother and infant. Spinal and epidural morphine provide effective analgesia with limited milk transfer. Following C-section, a multimodal approach that control postoperative pain is highly recommended and could improve breastfeeding.