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Lactation Information and Discussion <[log in to unmask]>
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Mon, 12 Jun 2000 07:56:32 EDT
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In her always articulate manner, Jean discusses the thread on epidurals and
Pitocin and pumping....

<< I think it is a mistake to jump to the conclusion that the pump or the
 epidural or the pitocin must be at fault. Only when the sinuses become
 somewhat overdistended and accompanied by very full ducts behind them is
 there better potential for the pump to yield any appreciable volume.  >>

However, Jean, two things:  in our facility, most of the mothers are now
getting the epidural just prior to starting the Pitocin.  And, this is
occurring in mothers who do not get Pitocin induction -- or perhaps just a
little Pitocin stimulation towards the end of the labor, AND, it wasn't
nearly as prevalent several years ago when fewer mothers were getting
Pitocin.  In fact, when I was working occasionally at another hospital where
epidurals were NOT the norm, most mothers were able to begin to see signs of
colostrum and actually *collect* it within two to three pumpings.

I don't disagree that hand expression/compression is probably most effective,
but given the work of Uvnas-Moberg, I think it quite possible that the
exogenous pain relief in the form of epidural (and, perhaps, the
concommittant overuse of Pitocin) may be impacting the mother's own oxytocin
production.

The half life of Pitocin is only a couple of minutes which is why it needs to
run so continuously.  But when a mother gets Pitocin for 12 to 14 hours, it
does make one wonder.....

Jan --

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