Jennifer, you wrote:

< 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.>

My information and logic lead me to believe that the deliberate
overhydration before the administration of epidurals to help avoid
hypotension (abnormally low blood pressure) from the medications  is
probably what is responsible for the all-over-the-body swelling.

I would like someone much more knowledgeable than I to explain whether it
is the large amount of fluid itself that causes the swelling, or does the
administration somehow interfere with ADH release and/or kidney function.
Or does the simultaneous administration of Pitocin, prolonged IV drip or
intra muscular or intra-uterine in the case of a C. Section compete for
binding sites with ADH, since they share some of the same chemical
characteristics?

I think this is a situation ripe for research, though it would be
difficult to separate out just IV overhydration when other factors such
as pitocin and epidural medications are present in the same mother. I
cannot imagine any other circumstance in which a mother in labor would be
deliberately overhydrated, other than prolonged IV pitocin induction
and/or in advance of an epidural. Would people more familiar with
pharmacology and U.S. hospital management of labor please comment?

Jean
***************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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