Re: Linda Smith's post on suck problems after epidurals and vacuum extractions: I've worked with a few babies over the years who had feeding problems after vacuum extractions WITHOUT epidurals. Most often, the baby had no rooting reflex and extremely poor facial muscle tone; but usually had adequate tongue and jaw movement. It has been transient in the babies I've worked with, generally resolving in 3-4 weeks. It seems to be a temporary neuromuscular deficit, perhaps linked to pressure or fluid changes in the brain from the vacuum extraction. We've managed the problem clinically by effective pumping, coupled with finger feeding/suck training for a few weeks. The Dancer hand position has also been helpful. The babies I've worked with have made the transition to feeding at breast, when the mom was willing to make the considerable committment of supporting the milk supply and using the special feeding techniques. If anyone's looking for a research project, I'd love to see this pursued.