I really feel that we have a mutual goal to assist mothers with
breastfeeding.  Some mothers may choose unmedicated childbirth and that
is great.  Some mothers may not...in those situations I would rather
not have the mothers believe that they will have difficulty
breastfeeding.  Things like this can become a self-fulfilling prophecy.
(Well they told me that epidurals may make it harder so I will have
more difficulty with breastfeeding).  The literature we presently have
on epidurals does suggest that there is some potential short term
impact on latch...but no long term differences in breastfeeding rates
at 6 weeks.  The scientific literature also suggests that both
narcotics and epidural together have more impact on latch than either
by itself (which one might guess).  Not everything in my practice is
supported by scientific evidence...so I do take your anectdotal
evidence seriously...but have concerns about what we might inadvertily
suggest to women who choose to have labor pain relief.  I also believe
that this "choosing" mentality will put the medical establishment at
the defensive.  We are trying to educate physicians about the
importance of breastfeeding...let's not approach this from an either or
perspective.  Instead...let's look at this from a what can we do to
help be supportive of breastfeeding perspective.  (ie: morphine is
better for post-op pain control than demerol...shorter half-life and
less potential to adversely effect infant suck).  We need to study how
we can provide pain relief to women in labor who choose to have it and
how to avoid adversely impacting breastfeeding. Those women who had an
epidural for a long time before delivery and had difficulty getting the
baby to latch...did they get the baby to the breast early...or were
they too exhausted after the long labor and "had a rest" first? There
are many potential confounding influences here. By the way...I had 4
epidurals (the first for a prolonged time) and had no difficulties
getting my babies to latch...but we all are different and have
different experiences.  Lets try to be inclusive and see what we can do
to be helpful no matter how the mother chooses to experience birth.

Pamela

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