I would also be happy to show my case study to Kerstin. As every case is 
different, the one I presented is one of the most severe I have seen. Also, this 
woman had a home birth. NO epidural, no pitocin, no drugs of any kind. And, 
yet, she had the most severe reaction to Ejection I have ever seen. Again, as 
this is new territory, all the information we can find is helpful. 

It may even be one of the "unspoken" reasons why some women, with normal 
appearing lactation experiences, good supplies, no nipple pain ect simply quit 
breastfeeding, with the all to common excuses we hear all the time. I have not 
had 100 women relate these feelings with Ejection to me, but maybe some of 
them are afraid, because they think "There is something wrong" with them. (A 
common enough problem with too many women during this time.) 

When I have seen even mild unpleasant reactions to Ejection, they nearly 
always start just *before* Ejection, or at the *moment* of Ejection, and 
nearly always clear up within 90 seconds or so. 

It would be interesting to see if epidurals and spinals DO cause problems with 
Oxytocin Release. I, personally, haven't seen it, from the Ejection Responses 
of most postpartum breastfeeding moms, but it really should be investigated. 
(Of course, drugs like Magnesium Sulfate are an other story. They do cause 
myriad problems with Lactogenesis, in so many cases.) 

But, blood work, on willing women, of course with a Control Group of women 
who had no drugs during labor, would be very helpful. Oxy is hard to catch on 
blood work, as the rise is so quick, and most women are probably not crazy 
about the idea of a venipuncture during her first attempts to nurse her 
newborn. But, I am sure there is a way to do it. (Of course, getting a study 
group, and a control group,  which can be related to the majority of women 
might be difficult.) Also, I am not remembering the half life of Oxy, I know it is 
very fast. Even with medicated births, Oxytocin is present, and I don't know 
how we could tease out "Birth" Oxy Release from "breastfeeding" Oxy Release. 
But, I am pretty sure more research can be done to figure it out. I need to be 
honest, until we have Evidence Based Information, I can't tell women that 
Epidurals may cause problems with their Ejections. (especially since I haven't 
seen it in practice in 20 years.) Definitely, research in this area needs to be 
done, so we will have Evidence Based information to help the women we work 
with. 

As per personal experience, I had long labors with my first two, (android 
pelvis) followed by Epidurals and C Births. I had a C Birth with my third, with a 
Spinal Anesthetic instead of an epidural. I don't know what non-medicated C 
Section birth feels like (and with C Births, I would prefer not to :) !) but, I 
know I never, personally, had any issue with Oxytocin Release or processing. 
But, one anecdotal case alone isn't proof. 

It would be very interesting to see a well controlled study on Oxy production 
and release with and without Epidurals. Of course, in so many births, Pit is 
used, and even given after birth (especially in either mechanically assisted 
births, multiple births, and C Births) that it would need a lot of factoring in of 
many different situations. 

Interesting stuff. Indeed. 

Mary Jozwiak IBCLC, RLC, LLLL
Private Practice 

On Tue, 15 Apr 2008 09:09:28 +0200, Marianne Vanderveen-Kolkena 
<[log in to unmask]> wrote:

>
>**Kerstin told us about the drop in oxytocin and what I found really
>interesting and what might be a nice little research project for those 100
>moms you mentioned, Diane, is that Kerstin made a link to epidurals. At
>labour/birth, there is clearly a high oxy level, but few minutes after
>birth, with s2s, levels are even higher, she said. Mother Nature's whole
>idea behind this is that oxy helps with the transition to maternal
>behaviour. Oxy priming happens in this phase of motherhood. The problem 
with
>an epidural is: it blocks pain stimuli through the spinal cord (which it is
>supposed to do), but it *also* blocks the high oxy surge that is supposed to
>help establish this transition! Kerstin said that women with epidurals don't
>really know they miss out on oxy benefits, because they are not primed in
>these first few minutes. They seem to be more even, less emotional. They,
>sort of, don't have the nice ups and also don't have the sad downs.
>Nevertheless, Kerstin wondered whether the overabundant use of epidurals
>might be the cause of a generation or even consecutive generations that
>partly lose the beneficial effects of oxy and thereby experience blunting of
>the loving system, that oxy protects.
>So, I now wonder, whether these are moms who had an epidural and if this
>epidurals might have caused some suppression of oxy first, but because
>Mother Nature is so strong, levels rise despite of the initial lack and now
>cause more down effects. I don't know... it is mere speculation, no research
>whatsoever to back up this idea of mine, but I'm just thinking further what
>Kerstin told us.
>And like Karleen, I think she would be greatly interested in receiving
>information from us. We might forward the Lactnet-mails concerning these
>cases, if posters are okay with that. Either Karleen or I could do that...
>
>Warmly,
>
>Marianne Vanderveen, Netherlands
>
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