>Dear Folks:
>    Just a reminder on this thread about the research showing that epidurals
>didn't have a negative impact on breastfeeding initiation or duration if
>there was strong breastfeeding support in the hospital.

To add to this - I am not aware of any anecdotal evidence, or perception,
that epidurals lead to problems with bf initiation or duration in the UK.

I think epidurals have their problems - for example,  the way they are now
regarded as almost routine in some units, as I feel this is disempowering
for women, and the way they lead to further interventions which bring their
own problems with them .

This in itself may have an impact on bf, of course, rather than anything
pharmacological to do with the epidural.

However, there is no reason to assume, as far as I can see, that epidurals
should have an impact on bf

What is far more important, in my experience, is

*  having nothing in ward routines that prevent or hinder early (immediate)
post partum contact between mother and baby, a contact that lasts as long
as mother and baby want
* support and help when necessary for early and unrestricted bf
* no suctioning unless medically indicated - fortunately, deep suctioning
is rarely done in the UK now

I see far more mothers whose bf has been messed up because of diamorphine -
this leads babies to be sleepy for ages, and then bf has less chance of
getting underway confidently and happily until 2 or more days have passed.
2 days is more than enough time for mothers to be demoralised and midwives
to mess up. Give them 3 days, and you can have a really huge problem.

Diamorphine is known and accepted as a major messer-up of bf, but that
doesn't prevent its promotion.

Lactnet: what's your experience of diamorphine?

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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