Dear all,

First of all, happy Nurses' Week to all the nurses on the list.  I was
actually remembered with a lovely flower and a box of Fannie May chocolates
by our peds office!  Maybe someday we'll incorporate LC Day into BF Week!

Comments on Lisa's post re drugs in labor, etc. etc....

1.  Yes, all labor drugs get to the baby.  ANYTHING that goes into the
mother's blood stream will cross into the baby, whether or not it is
pethedine (the drug used in the Self Attachment video), Nubain, Stadol,
demerol, etc.  These are all CNS depressants, and will affect the baby in
some way, shape, or form.  Ask the docs why they have Narcan on hand.  Ask
them why they try & avoid giving the mom narcotics shortly before delivery?
 Ask them to read Brazelton's work on narcotics -- I believe (don't quote me,
but someone must have the reference) he states that narcotics given in labor
can affect the baby in some way for up to a month after delivery. (Found it:
 Brazelton, TB.  Effect of prenatal drugs on the behavior of the neonate.  Am
J Psychiatry vol 126, March 1970, 1261-1266.  There are scads of references
-- Linda Smith posted a whole bunch on 1-30-96.

Look at this one for interest:  Jacobson B, Nyberg K et al.  Opiate addiction
in adult offspring through possible imprinting after obstetric treatment.
 Br. Med J. vol 301, 10 Nov 1990, 1067-1070.

Look at Kraemer, H. Obstetric drugs & infant behavior:  a re-evaluation.  J.
Peds Psych. vol 10, 1985, 354-353.

Matthews, MK.  The relationship between maternal labour analgesia and delay
in the initiation of bf in healthy neonates in the early neonatal period.
 Midwifery 1989: 5, 3-10.

Righard & Alade, Effect of delivery room routines on success of first bf.
 Lancet, 1900 vol. 336, 1105-07.  This is the article from whence the video
cometh.

Sepkoski et al.  The effect of maternal epidural anesthesia on neonatal
behvior during the first month.  Developmental Medicine & Child Neurology.
 1992: 34, 1072-80.

Anyway, the list goes on.

At our hospital, some of the OB practices use Nubain, some use Stadol.  As
far as effects on the baby, it is probably 6 of one & half dozen of the
other.  It's really hard to separate out whether it is the Nubain, the
epidural, the separation of mom & baby, the first water, the lack of bf in
the DR, whatever.  I can't say that I have ever been able to pinpoint a
specific behavior (or lack of it) and say, "Aha!  Nubain at work here!"

If bipivucaine from an epidural has been seen in the cord blood of an infant,
then Nubain from an intrathecal will also get into the baby.  There is no way
around it!  Anything that gets into the mother's system is going to get tothe
baby.  Around here, the docs don't want the moms to drink caffeine, eat
chocolate, or consume anything with Nutrasweet during pregnancy.  But they
blithely give narcotics during labor.  Go figure!

OF course your anesthesiologist hates the Righard video.  Natural childbirth,
with all its attendant lack of medication & anesthesia, means more work for
the nurses to support during labor, less money for the pharmacy for drugs,
less money for the anesthesiologists for epidurals (or whatever), though they
have to be on call just in case. Ascribing to the tenents of the Righard
video (minimizing labor medications & keeping mom & baby together until the
first bf is accomplished) interrupts the nicely established flow of the L&D
area, and makes more work.  Can't get the room cleaned up quickly.  Can't get
the vitals done immediately.  Can't get the mom & baby fingerprinted within
the first hour -- and of course, we all know that if we don't do it within
the first hour, (a) we'll forget to do it, and (b), a baby snatcher will come
into the labor room and steal the baby.

Don't know what you'll find re moms eating in labor. I do know that in the
Family Birthing Center in Southfield (established 1979) all mothers were
given anything they desired to eat/drink during labor.  Less nausea &
vomiting than over in the regular hospital where they were given ice chips
only.  No aspiration.  It was great.  And, keep in mind we had a bf rate of
98.7% and virtually NO problems with bf there.  Sigh.  Those were the
days....

Frankly, I think that just as bf is/should be the norm and the standard
against which growth & development is measured etc etc, so home birth should
also be the norm & the standard against which hospital protocols are
measured.  (Yeah, right.  Like that would ever get anywhere.)  I take it the
hospital allows moms to drink?  That's great!  And yes, juices should be
allowed.  (As should anything else, but that is another story....)

Oh dear, Lisa, you pushed one of my buttons.  Back into my shell....

Jan Barger