Breastfeeding after an epidural

If you’re wondering whether having an epidural will affect your breastfeeding journey, you’re asking an important question. The way you give birth and the pain relief you have can both influence your early breastfeeding experiences.

However, with right information and support, any effects are usually short-lived. Here’s what to expect, what you can do and how to get support if you need it.

An epidural or spinal is a way to manage pain during labour or caesarean birth. It involves a small tube or needle placed in your back to deliver pain relief. The medication is usually a mix of local anaesthetic (to numb nerves) and a small amount of opioid (for extra pain control). 

Most medications given during labour can pass from you to your baby, including those used in epidurals. But the doses used in epidurals are much smaller than those given by injection or IV, so less medication reaches your baby.

If you receive an epidural or spinal, you will still be able to breastfeed. However, some types of pain relief and the way birth unfolds can shape the early days of breastfeeding¹ and you may need additional help and support. A few things to be aware of: 

• Higher doses of fentanyl (the most common opioid in epidurals) may affect breastfeeding, but lower doses usually don’t.
• Some babies may be sleepier at first and take longer to be interested in attaching to the breast. This is especially so if you’ve had pethidine.² Hold your baby skin-to-skin as much as possible. In time your baby will become more alert and start moving around and showing feeding cues.
• Epidurals may affect your natural oxytocin release³ (oxytocin triggers the let-down reflex and helps with bonding). Early and ongoing skin-to-skin contact with your baby will help boost your oxytocin levels. Other things that help are gentle touch or massage (like stroking your arm or a gentle back rub from your support person), and creating a calm, private space (dimming the lights, limiting noise and visitors).
• While your IV drip and urinary catheter are in place, you may feel numb and have limited movement. You might need support to get yourself and your baby into a comfortable position to breastfeed.
• You will receive fluids through your IV drip to help prevent problems with your blood pressure. This can mean you have extra fluid in your breast tissue.⁴ As your milk supply increases, this extra fluid may make your breasts feel swollen, firm, and tender, known as engorgement. This can make it harder for your baby to latch and for milk to flow well at first, but frequent feeding and gentle techniques can help relieve it.
• For some mums, milk takes a little longer to increase in amount and change from colostrum to mature breastmilk (sometimes called your milk ‘coming in’).⁵  There’s no need to do anything special, just keep feeding your baby as often as possible and it will happen. 

While there are some things to be aware of, it’s important to remember that having an epidural is a valid choice for managing pain during labour. With the right support, most mums and babies do well, and you shouldn’t let worries about breastfeeding stop you from choosing the pain relief you need.

What to do

After the birth, aim for skin-to-skin contact for at least 90 minutes if possible. This helps your baby get to know your feel and smell and helps them find your breast more easily. From then on, keep your baby close, offer the breast as often as you can, hand express if needed, and ask for support. Most early effects are short lived when you have the right help. 

Getting the support you need 

• Talk to your anaesthesia and obstetric care teams about any concerns. Discuss how the amount and timing of any drugs given could affect you and your baby.
• Learn as much as you can about breastfeeding before birth. Attend a Breastfeeding Education Class if there’s one available locally or a live-streamed interactive Breastfeeding Preparation Session webinar.
• If you have trouble, reach out for support. An ABA breastfeeding counsellor can talk you through helping your baby attach and feel well and how to tell if they’re getting enough milk.

© Australian Breastfeeding Association December 2025