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Date: | Mon, 13 Nov 1995 18:42:51 EST |
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This is the second time today I have written this. My previous
Prodigy line failed. So now I hope I can
recall everything I previously wrote. First of all, Kathy Auerbach
review the "Anesthesiology" article
in question, (83:300-08, 1995) and raised the following concerns:
1. The three goups of babies are defined by the medication they
received. There is NO control group
of infants who were NOT exposed to medication.
2. They contend these meds have "no effect" on the baby, but how can
they know this when they did not observe the babies? All that is
mentioned is the activity of the babies. This term is undefined.
What do they mean by activity? Fussiness? Other studies have noted
that babies so exposed are fussier/and or cry more than babies not
given epidural meds via the placenta. There is no mention
of suckling activity, a key in determining whether these meds truly
AFFECT babies, since this is a
necessary survival skill of newborns. Furthermore, if the babies
were observed feeding, what kind of feeding was it? the relatively
passive---given by someone else, bottle feeding, or the much more
inititative--requiring breastfeeding? No one knows. This is not
mentioned.
So, I want to know what the Lactnet docs are thinking. What kinds of
behavior should be measured and what assessment tool should we
consider. I first thought of Mulford's. Who has other
recommendations? I am also thinking about methodology of this study,
and invite recommendations..
I would like to raise issues such as: How can the amount of the drug
realized by the baby be controlled? The placenta is a big bloody
sieve.... One of the docs I spoke with felt that whatever
small amount of med went through the epidural was broken down by the
liver of the mother. Would
anyone like to comment?
Additionally, I would like to invite the comments of other LC's in
various settings to share with me so that I may share more concerns
with my docs here....I don't want to be the lone LC on the soapbox I
want lots of company! Either E-mail me privately or call at (407) 482-
2670 or mail written comments to:
Donna Corrieri IBCLC
10316 Sunstream Lane
Boca Raton, Florida 33428
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