Dear Friends:
Thank you Mary, for getting back to us about this questionable finding,
that epidurals make little or no difference to breastfeeding.
I am perplexed at the lecturer's use of Baumgarder, who found that
"epidural anesthesia during labor is negatively associated with early
breast-feeding (sic) success despite not inhibiting early breast-feeding attempts." The
authors also state that they didn't do any long term follow-up.
Halpern showed that Baby-Friendly style practice did promote
breastfeeding, and studied women out to 6 weeks, where 92% were still breastfeeding, but
not all exclusively.
Baumgarder makes a lovely comment that "an additional unexplored
explanation for the apparent negative effects of epidural exposure......is that
mothers willing to accept one intervention (epidural) are more willing to accept
another (bottle supplementation).
Sepkowski identified that newborns exposed to epidurals were less alert.
Riordan showed that breastfeeding assessment scores (using the IBFAT scale)
were statistically higher in unmedicated mothers.
The Cochrane data base says that "Epidural analgesia appears to be
effective in reducing pain during labour. However, women who use this form of pain
relief are at increased risk of having an instrumental delivery."
I am also interested to know if this OB/GYN ignored Matthiesson,
Ransjo-Arvidson and others that showed a negative impact on breastfeeding when
labor analgesia, including epidurals are used?
True, studies of epidural use are difficult to standardize: medications
in the epidural vary, women may receive IV narcotics before the epidural is
given, epidurals are given at different times in labor. Still, as epidurals do
lead to increased chance of operative delivery, which leads to maternal and
infant injury and separation, we can't for one minute accept that there is no
connection between epidural use and breastfeeding.
How was this lecturer discovered to be a breastfeeding advocate?
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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