Martha and all,
    I have seen this, too. Although my experience is in a small hospital
here in Phoenix with lots of Hispanic moms.  They are like your Birth Center
clients, very few requests for meds or epidurals.  Now am in a Lactation
practice in a growing hospital with most moms expecting their epidurals as
they 'back into' their labor rooms to be admitted for birthing!
    I see all varieties of sleepiness and unco-ordinated suckling or
latching with no suckling.  I work and work at waking them up, sometimes
it's no use.  I say, "you can lead a horse to water, but you can't make them
drink".   I encourage lots of skin to skin holding and cuddling by either
parent along with time and patience.  Then, there is the problem of
convincing the staff that babies that need to be fed, should have a feeding
by cup or dropper. But, these babies are just too deeply sleepy.
    We are really working with the normal sleep pattern after birth,
accentuated by drugs.  The epidural rate here is at least 80% and they last
for 2-10, sometimes more, hours.
    I have taken the stance to tell parents to be active in waking babies up
every 2-3 hours.  If they 'snack' that is great, but not to allow long
intervals between because they are drugged and need the stimulation and so
do her breasts!
    This problem here in the US is a bit out of control, I believe.
Is there any hope for us??
                           Betsy Wells-Gephart RN, IBCLC
                             Chandler,AZ
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