Hi Marie -- sorry about your dope MD correspondent.

However, the best advice I could give myself, if I were replying to this guy,
would be to try to imagine that I were Barbara Wilson Clay.  Her tone is just
the right one for this guy, I think.    Something like,

1. "Glad you read my site.   I see you aren't acquainted with the IBCLC
credential.  Here it is, here's what it involves, here are other sources
(IBCLE, etc - you'll know better than I will, Marie) for you to learn about
it. "  -- Note -- the key here is that even though his tone has been abusive,
yours is welcoming and not what he deserves.  Your taking the stance that if
he only understood he'd be on your side.  Probably this is wishful thinking,
but occasionally one really does make a convert this way.

2." I was only writing about epidurals in childbirth, of course many other
terrific uses.   And we're all grateful that they exist even for childbirth
-- couldn't have emergency c-sections w/o some anesthesia, etc.  But like all
med procedures, some upsides and some downsides, and its always important for
us to remember that every intervention is a tradeoff."

3.  "Here's what there is in the peer reviewed literature.  You're right,
it's limited, and peer review really is the gold standard" -- Marie, imagine
you are Marie Biancuzzo writing now! -- "And in fact it does seem that in
hospitals with really top-notch breastfeeding support, such as Evergreen,
etc, there is no negative association between bf success and epidural
anesthesia in labor.  But very few US hospitals have that quality of bf
support, and, in light of that, the many anecdotal reports from experienced
lactation clinicians have suggested that the physiological effects of
epidural anesthesia on bf will be a fruitful area for further more formal
studies.   Some of those are now taking place" (is this true? anybody out
there?)  and when their results are in you can be sure that I will be
updating my website in light of them.

4.  Meanwhile, I would never say -- and don't say -- that nobody should ever
have an epidural.   But it is responsible to make clear that there are
reported adverse effects, so that laboring women can make informed choices.


In fact, I'd go further -- ask him if he would like to help your study by
reporting on the subsequent breastfeeding success of his epidural patients!
Probably he's never thought of this before in his life.   And while it is
hugely unlikely that he'll really be in touch with you about them, if it
prompts him, some time, to talk to his local LC about this, or even to look
in on his patients postpartum and ask them how their bf is going, this is a
pure gain for the world.

Good luck lighting this recalcitrant candle --

Elisheva

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html