Just checking in to say what we do here in Norway.
Ropivacaine seems to be a first choice for epidurals in labor and we
practice absolutely no restrictions on breastfeeding in connection with it,
no matter how long the epidural was in place before birth or how much drug
the mother got.  We just act like nothing happened and put baby to breast.
I did find it amusing to read in our reference work on pharmaceuticals that
all the regional anesthetics pass rapidly over the placenta and into the
fetal circulation, where they can have cardiac effects - the common line
here is that epidural anesthetic has no effect whatsoever on the fetus or
the baby, so really all women could just have epidurals.  (Luckily we don't
have a surplus of anesthetists so our epi rate is still acceptably low!) The
reference work we use is compiled by some group of publicly appointed
experts and unfortunately is written in Norwegian so will not help most of
you much, I'm afraid.  But you can safely quote me that in Norway we
practice no restrictions on breastfeeding as a result of ANY labor
medications.
These anesthetists who came up with this modern version of primitive
colostrophobic practice should be forced to produce hard evidence that
letting the babies suckle freely after use of ropivacaine in labor, is
harmful.  They should also be required to show beyond a doubt that depriving
the babies of the colostrum is safe.  Last but not least they should be
relieved of their delusion that it is up to them to decide what a mother
does with her breasts and her baby.  Last time I checked, mothers in
maternity units were not routinely declared incompetent by a court of law
and therefore still had their basic human rights, at least in theory.
Paternalism on the part of health care professionals is a continual threat
to the exercise of those rights in many places.
I took a look at AstraZeneca's website (they make ropivacaine) and can't
find any sign of direct involvement in infant food.  It was an interesting
exercise anyway.
Rachel Myr
who works in a maternity unit herself and fights paternalism when necessary,
here in sunny
Kristiansand, Norway

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