In a message dated 3/27/00 10:58:45 AM, [log in to unmask] writes:

<< I am not aware of epidurals being associated with poor bf experiences, but
I would not  be sure of this, as mothers can have poor bf experiences in
any circumstances. The first time I came across people who were sure it
happened because they had seen it was from US posters to Lacnet.

So I would be really interested to learn if epidurals for 24-36 hours are
common elsewhere,  as Rachel reports, and to speculate if this mega-dosage
is why  US practitioners feel there is a clear link between epidural use
and poor bf. >>

Having worked doing hospital labor support as well as been extensively
involved in homebirth, I can tell you that I do not believe that epidurals
for such long periods are the cause of their effects on bf. It is the use of
epidurals *at all*. Unfortunately, as someone mentioned earlier, there are
unlikely to be very many adequate studies done about this, since those in
power would not profit from the outcomes. I would suggest that those who do
not believe they see any impact on bf from epidurals ask themselves how many
births they ever see w/o epidurals (or other meds), esp among primips? To
what baseline of any biological norm can you compare your observations?
Having worked in a hospital w/ a very high epidural rate, I can imagine I
might have presumed that the sleepy, non-responsive babies I saw were normal
newborns had I not had personal experience of homebirths (these babies were
rarely exposed for 24-36 hours). IMO, the more supportive a culture is of bf,
the more likely it is that these effects will be overcome, but it does not
mean they are not there. Recently, I have come across information (I believe
this may have been discussed on LACTNET) that suggests that flattening of the
nipples and swelling of the surrounding tissue may also be linked to
epidurals. I have not yet found the source for this (anyone have it?). This
would certainly explain the very large numbers of women who appeared to have
flat nipples in the hospital. Epidurals also lead to septic workups, vacuum
extraction, increased use of pitocin and other interventions. Many babies are
forced into an acynclitic position due to the epidural and thus push for way
too long, causing possible compression of vertebrae in the baby's neck. This
question is rarely ever asked: "Is the premise that it is beneficial to
artificially relieve pain in birth valid?" IMO, all interventions in birth or
bf should have to be proven to cause no harm before they are used
judiciously.
Jennifer Tow, IBCLC, CT, USA

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