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Subject:
From:
Jan Barger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 18 Apr 1995 08:09:48 -0400
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Hi all!

Re:  Pit induction & edema.  Thanks for your input on the possibility of the
epidurals causing the meaty nipples and the edema in ankles.  Interestingly
enough, despite an 85% epidural rate, I don't see the meaty nipples/edema in
women who have just had an epidural and who have not been induced.  Since I
don't know when I last saw a mom who was induced that did NOT have an
epidural, I'm hard put to say it was the Pit and not the epidural.  Perhaps
it is the combination of the two....I realize Pit is carefully titrated and
given with "relatively small amounts of fluid" but is this a side effect of
the drug?  Or is it a side effect of the volume of fluid?  Or, is it a side
effect of the drug in combination with the fluid overload?  I dimly remember
seeing it (the edema) in women who had received Pitocin induction back in the
70's and 80's (I go back a LONG way) before epidurals were used at all, but
assumed, along with everyone else, that this was a "normal" consequence of
some labors....sheesh.  Any other thoughts?  I'll history take more carefully
on all the moms I see with epidurals - with or without Pitocin.

Re:  Syntocinon - has an extremely short shelf life which is why most
pharmacies don't carry it.  It has NOT been withdrawn from the market, but is
hard to get because of that reason.  The only place that carries it around
here that I know about is the hospital - none of the pharmacies anywhere
else.

Re:  Early d/c & dehydration:  I sympathize with you on the early d/c
problem.  My concern is that in all this, breastfeeding will be blamed yet
again, and we'll be back to routine water after every feed "until the milk
comes in" rather than assuring that moms and babies are feeding well prior to
d/c.  After all, if they can take a bottle, they can feed.  Right?  And, if a
baby does die, who will be blamed?  The hospital?  The docs?  The nursing
staff?  The insurance company?  Breastfeeding advocates?  (For "making" this
mom breastfeed?)  I do think that it is a real problem that there is no
followup until 14 days.  Is there nothing that can be done about that?  I
think if a mom is d/c and the baby hasn't had at least 2 or 3 GOOD feeds, the
doc's office should be notifed by the hospital staff that this mom/baby is at
risk for dehydration.  At the very least, that would improve communication.

Jan Barger

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