<Rachel says,

<< Hoping to keep Lactnet discussion above the belt, >>

Jan says

<Keep in mind that there was a study that showed that epidurals DO impact
breastfeeding, as do many other birth interventions, so if you have some
suggestions about how to minimize the impact thereof, please share it
with
the group.>

It occurred to me the other day after one of you said something about
"epidural cocktails", that all this time, when we have been talking about
epidurals, we are using a word which describes a only a route and site of
injection. But it is the individual medicine(s) used that seem to have
potential to "snooker" the baby somehow,  in some cases.
Anesthesiologists of course, disagree strongly on this point!

Any study of "epidurals" and their effects on breastfeeding would seem to
be comparing oranges and apples if one particular set of drugs is used by
one anesthesiologist and another combination by someone else. Or at one
institution vs. another, if the practice in a certain institution uses
one medication protocol only, while another is used elsewhere.

One thing I do believe they all have in common is copious IV fluids in
order to maintain good control of the mother's blood pressure. I have
observed that mothers who receive IV's in labor for any reason often seem
to retain fluid. Sometimes pitting edema is noticeable for as many as
10-14 days postpartum. At least part of this fluid overload collects in
the breast, adding difficulty to satisfactory initiation of
breastfeeding.

A third confounding factor in regard to swelling, it seems to me, is that
of pitocin in the IV's: how much total, how long administered during
labor, and continuing after birth, including even into the uterine muscle
during CS. While pitocin has nothing directly to do with epidurals, the
two are frequently being administered simultaneously, and the use of one
often seems to increase the use of the other.

It would be difficult to separate out the medication factor(s) from the
IV fluid factor in researching epidural effects, but each factor might be
producing different difficulties in early breastfeeding. Does my
reasoning make any sense to anyone else?

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

___________________________________________________________________
Get the Internet just the way you want it.
Free software, free e-mail, and free Internet access for a month!
Try Juno Web: http://dl.www.juno.com/dynoget/tagj.

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html