I'm sorry, but the argument about epidurals causing decreased muscle tone and
therefore an increase in inverted nipples just doesn't make sense to me.
Believe me, I'm no huge fan of epidurals, although I have seen cases where it
was medically indicated (including my first birth, where it was pretty
clearly a case of epidural or C/S, so epidural seemed the lesser of two
evils).  But epidurals have basically no significant effect on musculature
above the umbilicus, so they shouldn't have any effect on the muscles around
the areola.  Furthermore, although there is some evidence to suggest that
babies whose moms had epidurals may have an increased risk of colic, they do
not generally have decreased muscle tone themselves.  The drugs from the
epidural should not pass through to the baby.  More often than not, IMHO,
babies are worn out at birth when mom has had an epidural because it prolongs
labor, especially second stage.  This, more than anything else, may
contribute to babies' initial difficulty in BF, especially if mom has sl
inverted nipples.  I just cannot see  a way that an epidural could cause
inverted nipples.

Elizabeth Steiner MD (FP, does tons of maternity care)

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