My copy of JOGNN came today and I was quite intrigued by an article on "ultra
low dose epidurals and the effect on breastfeeding.'" The sample size was
quite small and the author concluded that there was little effect on suck, etc.
The last portion of the article was a challenge. I don't have it right here but
in effect it said "we shouldn't focus on the effect of epidurals on
breastfeeding...many women place pain relief as a higher priority than
breastfeeding....don't need to make them feel guilty about it" (this last one is not a direct
quote - just my take.
       Well, for the last two weeks, I have noticed at least 2-3 babies a day
who can't suck, not the breast not a bottle, not my finger...nothing. When
they "attempt" to suck, they bunch their tongues, push the nipple out of their
mouth, chomp and clamp. We have noticed this in several bottlefed babies as
well. We actually had to gavage a baby last week to get some intake. So today I
took a big chance and left a message for the head of anesthesiology asking if
something new was being added to epidurals and what he thought was going on.
Will report back when I find out.
       This article is going to get a comment from me. Seems to be right
along the lines of "we don't want to make them feel guilty." But I'm struggling
for an explanation. What do we say, nicely, to a mom when her baby just can't
suck right? It's hard but they need to know something is causing this behavior.
One mom actually argued with me. Said "he nursed fine before you came in."
But he had not had any stools or wets since birth more than 12 hours ago.
Couldn't get colostrum with hand expression. No one saw him nurse. Can't suck right
on ANY bottle nipple that we tried. Sigh....
Mary Kay Smith, RN, IBCLC
Romeoville IL

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