Hi all,

I, too, use the video in my BF classes, & explain that the "medicated labors" in the research involved Demerol, not an epidural.

But, then I share something Dr. Righard shared w/us here in St. Louis a few years ago, when he did Grand Rounds at one of our local hospitals. He had a theory about epidurals' impact on newborn behavior, but had not yet conducted clinical trials to verify it (and I tell my students this--that this is THEORY, not EVIDENCE--yet!).

His theory was that, when a mom gets a "good" epidural--that is, experiences no pain or discomfort for the last half of labor--she does not secrete endorphins, the body's natural response to pain. Endorphins have been found to not only reduce an individual's perception of pain, but also to energize the person--hence, the "runner's high".

Since endorphins flow freely across the placental barrier, babies born of an epidural birth do not have the benefits of maternal endorphins, to energize yet calm them. Hence, we have sleepy, disorganized babies. Whether or not the epidural meds get through to the baby, the nonexistent endorphins DON'T.

Makes sense to me, & to my students. So, I encourage them to employ as many non-medical comfort strategies as they can, and if they do opt for an epidural, to request the lowest possible dose at first, to "take the edge off" the pain rather than eliminate it completely.

Again, this was just a theory, and I have yet to see any published results from the good dr. Has anyone seen any literature about this in the last few years?

Another question re: choice of epidural meds. Lately I've noticed more & more babies w/disorganized suck, poor latch, etc. & I've wondered if there's been a change in the "cocktail" our anesthesiologists are using. Haven't had the time to do a chart review yet, though.  I know some research (sorry, don't have the citation here at home--can get it at work tomorrow if anyone wants it) indicates that bupivicaine has a smaller impact on bf than other "aine" drugs in epidurals. Has anyone else seen a link between the meds used in the epidural (aside from the obvious narcotic ones) and babies' behavior postpartum?

Smiles,

Carol
Carol Schlef, RNC, MSW, IBCLC, LCCE
www.humorhealthhugs.com

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