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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
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The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from...
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Changes in milk composition associated with pethidine-PCEA usage after Caesarean section.

Wan Jun Tie1, Hazel Gardner1, Ching Tat Lai1

  • 1School of Chemistry and Biochemistry, University of Western Australia, Perth, Western Australia, Australia.

Maternal & Child Nutrition
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Summary

Pethidine patient-controlled epidural analgesia (PCEA) did not significantly alter breast milk

Keywords:
Caesareanbreast milk compositionbreastfeedinglactationpethidine-PCEA

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Area of Science:

  • Biochemistry
  • Maternal-fetal medicine
  • Lactation physiology

Background:

  • The impact of pethidine patient-controlled epidural analgesia (PCEA) on breast milk's biochemical composition and secretory activation timing remains under-investigated.
  • Understanding these effects is crucial for assessing infant nutrition and maternal recovery post-partum.

Purpose of the Study:

  • To compare the biochemical timing of secretory activation in breast milk between women undergoing vaginal birth and those with Caesarean birth receiving pethidine-PCEA.
  • To analyze the influence of pethidine-PCEA on key breast milk components, including protein, lactose, sodium (Na+), and potassium (K+) ions.

Main Methods:

  • Daily breast milk samples were collected from 36 mothers (17 vaginal, 19 Caesarean with pethidine-PCEA) for the first 265 hours post-partum.
  • Protein and lactose concentrations, along with Na+ and K+ ion levels, were measured.
  • Statistical analysis employed linear mixed effect models across three post-partum time periods: 0-72h, >72-165h, and >165-265h.

Main Results:

  • In the initial 72 hours post-partum, vaginal birth mothers showed significantly higher lactose concentrations (5 g/L).
  • Between 72-165 hours, vaginal birth mothers had lower protein and Na+ concentrations but higher K+ levels compared to the Caesarean group.
  • No significant biochemical differences were observed between groups after 165 hours post-partum.

Conclusions:

  • Biochemical indicators of secretory activation were present by 72 hours post-partum in both birth groups.
  • While initial variations in breast milk components were noted in the pethidine-PCEA group, these differences resolved by 165 hours.
  • The effects of pethidine-PCEA on breast milk biochemistry appear transient, diminishing by 72 hours and undetectable by 165 hours post-partum.