Thank you to all who responded with references re fever and epidural use.  I
originally asked because I had a couple of references but wanted to be sure
what I had was up to date; I also was in a hurry to forward this info feeling
I had to cover my bases (or rather, unmentionable body part).

I'd appreciate feedback on the scenario that led to my need for references as
it's one of those how and what info does one give mothers despite the risk of
liability in the eyes of their HCP's.  Briefly, this mom induced at 41 wks,
due to being 41 wks, so hours of pitocin, then epidural, luckily vaginal
birth.  She had fever and baby separated from her for 12 hr, no BF or even
allowing her to hold her newborn.

During HV I gently informed her that fever can accompany epidural use and her
problem with engorgement (I don't know how severe-tho baby couldn't latch
because I saw her after the fact after giving her phone instruction to tx
engorgement) may have been exacerbated by pitocin; gave her this info for
future use and said so to her.  In my written report to Ped (cc OB) I stated
what info I'd given mom.  I received a call from OB asking for references re
epidural and fever since she'd not heard of it and "couldn't it be work and
duration  of labor that caused fever; wouldn't want this to be occurring, if
there truly was an association."  I said I'd email her references which I did.

My question: should I have handled this differently?  Should I have included
references with report?  Shouldn't an OB be aware of risks of drugs she's
using?  Yes, I was angry that this baby unnecessarily received formula (mom
gave during period of engorgement before calling anyone and "thinks baby got
ABM in nursery during 12 hr separation).  I tried to approach this without
anger and merely state the facts both so mom could be informed and doc could
see the snowballing sequence of events.  I wonder, too, could not this all
been avoided had mother nature been allowed to work and natural labor waited
for(there were no maternal or fetal problems).

I have no articles specifically on pitocin and fluid retention but Jan Bargar
pointed out that it is a known antidiuretic, IV fluids, etc.  Are there
references, research on this?
I haven't heard from OB since sending her info and plan to contact her to see
what she thinks since reading info.  TIA and hope we can discuss this on LN
further.

Barbara Latterner, BSN, RN, IBCLC  (sorry for length)

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