Two thoughts about Becky's issue of what is taught in prenatal classes about
epidurals and breastfeeding:

(1) If there really isn't much research/evidence, then not only do we not
know for sure if epidurals adversely impact breastfeeding, we ALSO don't
know if epidurals are neutral or advantageous with respect to breastfeeding.
  It seems it is up to the people proposing the INTERVENTION -- with all of
its potential side-effects, including longer labor, and everything that
might happen when you stick a big needle into someone's epidural space
(death, paralysis, infection, leaking CSF, headache, etc. etc. etc.) -- to
show that the medical benefits to the mother outweigh the risks to the
mother and the baby.  The mothers certainly, ethically, have the right to
know the risks, including the right to know that epidurals have never been
shown to be safe for babies.  And they have the right to know that __% of
the clinical lactation professionals on LactNet, the largest email list for
such people, have observed that babies whose mothers have had epidurals
often have difficulty figuring out how to breastfeed.  Parents have the
right to know about Righard's research and to see his video on "Delivery,
Self-Attachment."  Parents have the right to know (as Rachel Myr has pointed
out so eloquently in this forum) that epidurals seem to make less difference
*IF* the hospital has lots of IBCLCs to support the mother and the hospital
is dedicated to breastfeeding.  And parents have the right to know what kind
of a hospital it is they are delivering in.  Can the anesthesiologists at
your hospital provide evidence that the breastfeeding rates at, say, one
month, are the same in women who had epidurals vs. those who did not?  Or
among different types and lengths of epidural anesthesias?

To sum up that long-winded paragraph -- it should be up to the
anesthesiologists to provide the research you can cite to parents in
prenatal class showing NO ADVERSE EFFECTS OF EPIDURALS ON BREASTFEEDING AT
THEIR HOSPITAL.  It should not be up to you to have to prove that an
intervention causes harm.

(2)  The American Academy of Pediatrics, in conjunction with Johnson and
Johnson, hands out the J&J video "Amazing Talents of the Newborn."  You can
buy it from their web site for $12.50.  I highly recommend showing this
video to parents in prenatal classes.  The babies shown in the video do all
sorts of cool and amazing things in the first days/weeks of life.  The
babies in the video are all the result of unmedicated births.  Heck -- show
this video to the anesthesiologists and the ob/gyns and the neonatalogists
and ask them how many of the babies they deliver to epidural moms act this
way?  Probably the anesthesiologists, who only come around during labor
itself have NO CLUE about how normal undrugged newborns are supposed to
behave.  Ask them, why do they think Johnson and Johnson filmed babies from
unmedicated births, if epidurals have no effect on babies?

End of middle-of-the-night rant.

Kathy Dettwyler
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