<The title sounds positive with the *improved* technique, it also sounds
great
that it leads to a decrease in operative vaginal deliverys. But then go
on to
state it causes *APGAR scores of 7 or less at 1 minute were significantly
more common with the low dose group* and also *newborns had a higher
high-level resuscitation rate.*>

Roni,

I wondered about this too. I came to the conclusion that it meant that
many of the babies had a lower APGAR and required more rescusitation
BECAUSE they had been born by vaginal birth, (with who knows how many
forcep or vacuum extractions, etc.) rather than a C.Section, not because
of the low-dose epidural itself.

At least, theoretically it didn't sound as if there were as much
medication used, which one might suspect would result in the babies'
having lower residual medication in their systems, and hopefully less
sedation of their sucking instincts. I also hope it leads to mothers
needing less IV fluids, but that may be too much to hope for.

What I thought they were implying was that they had somehow shown that
those vaginal deliveries were more stressful on the babies than a C.
Section delivery would have been. ("Significantly" more common? By what
kind of research standards? That sounds quite a bit different than
"statistically" more common!) Just what mothers need-more scare tactics!

We can only hope that low-dose epidurals might show, after large numbers
of cases, good enough results to change anesthesia practices, and watch
for improvements in the subsequent breastfeeding situations.

Again, a fertile field for breastfeeding research, being sure to consider
variables such as total IV fluid types and amounts, plus the specific
doses and kinds of epidural cocktails.

Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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