found this while looking for something else!
We all know what the 'unintended' effects do to BF'ing!!

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12011872&dopt=Abstract

Am J Obstet Gynecol. 2002 May;186(5 Suppl Nature):S78-80.

Unintended effects of epidural analgesia during labor: a systematic review.

Lieberman E, O'donoghue C.

Center for Perinatal Research, Department of Obstetrics and Gynecology,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Epidural analgesia is used by more than half of laboring women, yet there is
no consensus about what unintended effects it causes. To evaluate the state
of our knowledge, we performed a systematic review of the literature
examining the unintended maternal, fetal, and neonatal effects of epidural
analgesia used for pain relief in labor by low-risk women. Our review
included randomized and observational studies appearing in peer review
journals since 1980.Much of the evidence is equivocal. Existing randomized
trials are either small or do not allow clear interpretation of the data
because of problems with protocol compliance. In addition, few observational
studies control for the confounding factors that result because women who
request epidural are different from women who do not.There is considerable
variation in the association of epidural with some outcomes, particularly
those that are heavily practice-based. Despite this variation, there is
sufficient evidence to conclude that epidural is associated with a lower
rate of spontaneous vaginal delivery, a higher rate of instrumental vaginal
delivery and longer labors, particularly in nulliparous women. Women
receiving epidural are also more likely to have intrapartum fever and their
infants are more likely to be evaluated and treated for suspected sepsis.
There is insufficient evidence to determine whether epidural does or does
not tend to increase the risk of cesarean delivery or fetal malposition.
Adverse effects on the fetus may occur in the subset of women who are
febrile.Women should be informed of unintended effects of epidural clearly
supported by the evidence, especially since epidural use is almost always an
elective procedure. Further research is needed to advance our understanding
of the unintended effects of epidural. Improved information would permit
women to make truly informed decisions about the use of pain relief during
labor.



Regards
Karen Clements
RM IBCLC
Melbourne, Australia

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