870: Exogenous Oxytocin for Labor Induction or Augmentation is Associated with a Decrease in Breastfeeding Success

To identify how the use of exogenous oxytocin for labor augmentation and induction affect breastfeeding success after vaginal delivery This is a retrospective cohort study of breastfeeding success after administration of exogenous oxytocin for labor augmentation or induction in term, singleton, vaginal deliveries in nulliparous patients at a large academic institution from 2017-2018. Breastfeeding success in the immediate postpartum period was measured by the presence of breastfeeding, the need for formula supplementation, the average number of breastfeeding sessions per day, and the average amount of time spent at each breastfeeding session. A total of 1,588 women met inclusion criteria during the study period, 753 (47.4%) of whom underwent spontaneous labor without intrapartum oxytocin use and 835 (52.6%) of whom required synthetic oxytocin for labor augmentation or induction. Women who required exogenous oxytocin were significantly more likely to be older, obese, deliver at a later gestational age, receive neuraxial anesthesia, and experience postpartum hemorrhage. After controlling for these factors, women who required oxytocin for labor augmentation or induction were significantly more likely to require formula supplementation (aOR 1.45, 95% CI 1.16-1.80) and have fewer number of breastfeeding sessions on average (β -0.09, p-value < 0.001). Women who receive exogenous oxytocin for labor augmentation or induction are more likely to require formula supplementation and have decreased number of breastfeeding sessions. Further work is needed to examine the long term effect of exogenous oxytocin on breastfeeding and to elicit the exact mechanism of this association; however, it is possible that this may be due to inhibitory feedback of exogenous oxytocin on the endogenous secretion of oxytocin from the hypothalamic pituitary axis for milk ejection. These women may subsequently require additional breastfeeding support for successful breastfeeding initiation and maintenance in the immediate postpartum period.View Large Image Figure ViewerDownload Hi-res image Download (PPT)