Dear Lactnetters,

I've followed the recent thread on breastfeeding, intrapartum epidurals &
other pain medications with interest.  I am a family doctor and an
epidemiologist.  I'm currently working on a critique of the literature on
this topic.  I've enclosed my working bibliography on this topic for those
who are interested.

I need your help.  I'm currently working on a pilot study of intrapartum
procedures (including epidurals and narcotics/sedatives) and subsequent
breastfeeding success.  I started this project solely because several LCs
I've met along the way kept asking me what was "wrong" with epidural
babies, why were they "like that"?  and what exactly did "they" "do" to the
mother anyway?

I need your observations and stories!  Please tell me what you have seen
and thought.  There isn't even a descriptive literature out there about
what kinds of things LCs & others observe about epidural babies.  Your
descriptions could be the beginning of a literature about this.  As someone
mentioned, most anesthesiologists will say that epidurals do not affect the
baby.  In fact, studies are not available to support this.  Most
anesthesiology studies, if they evaluate fetal/neonatal response at all,
look at things like Apgar scores which are totally inadequate to pick up
anything but the most severely compromised babies.  I think the jury simply
doesn't have enough scientific information to answer this question
adequately.  Although there are some problems with the studies, I think the
evidence regarding abnormal neonatal neurobehavior and epidurals is fairly
strong, but there simply aren't good studies published about the very
complex neonatal neurobehavior of breastfeeding.  None of the randomized
controlled trials on epidurals have looked at breastfeeding as an outcome.
That being said, your experience is critical here.  Long before things get
published in the literature, folks like you have anecdote, clinical
experience, educated hunches, beginning hypotheses and the like.

Please send me your comments, opinions, names of others to contact and most
importantly your stories!  Please include your snail mail address if you do
not mind.  I might ask you down the road if you would consent to having me
quote you in an article. Please help me to help you to help moms and babies
by replying.  Thanks in advance!!

Valerie King





Valerie J. King, M.D.
Clinical Scholars Program
CB# 7105
Chapel Hill, NC  27599-7105
919-966-3717
Fax: 919-966-2274