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This case study, indicates that the
findings have a lack of correlation between the cumulative epidural Fentanyl
dose and the discontinuation of breastfeeding within 3 months postpartum women,
who successfully breastfed in prior pregnancies. Of the 345 women enrolled in
the case study, 93% completed breastfeeding at 3 months postpartum, of which
77% discontinued due to maternal reasonings. From this, we conclude that the
Epidural solution with Fentanyl concentration as high as 2µg/mL does not
interfere with subsequent breastfeeding.

The outcomes further indicated that
of the possible 956 women that were eligible from February 2010 to January
2015, only 345 women were enrolled into the case study, from which 26 females’
results were inconclusive due to no follow-up for the 3-month assessment. The results
include no difference in the breastfeeding rate at 6 weeks and 3-month
follow-up period as the frequency at 6 weeks was 97% with no Fentanyl, 98% with
Fentanyl, and 94% with 2µg/mL Fentanyl. There was also no change in the sensitivity
analysis due to discontinuation, mainly because the reasonings are related to maternal
versus infant. Prior to breast-feeding, during delivery, women with no Fentanyl
showed an elevated motor block at the time of delivery when compared to women
who received 2µg/mL. At delivery, there were also variations in the cumulative
Fentanyl/Bupivacaine doses and the maternal plasma concentrations. However,
results show no variation within groups for maternal or infant recorded assessments,
except the umbilical cord venous Fentanyl and Bupivacaine concentrations.

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The primary outcomes included a
chi-squared analysis of the rate of breastfeeding throughout 6 weeks and
Pearson-Klopper method analysis of the breastfeeding rate change, which was
known to be the confidence interval that is determined via binomial
distribution of two possible outcomes that are performed multiple times. The
secondary outcomes included Kruskal-Wallis H test for continuous and interval
data of the Apgar scores and LATCH breastfeeding assessments. Dunn’s test with
Bonferroni correction was used for post hoc comparisons for rate of
mother discontinuing breastfeeding at 3 months and reasons for discontinuation.
The nominal data was further analyzed with chi-squared analysis to determine
possible rejection of null hypothesis (P value

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