Cindy,

I really don't believe we have any good scientific data on how epidurals
effect breastfeeding.  The closest would be Marsha Walker's lit review
which was published in the JHL 13 (2) 1997.

It is a good review..but it does not answer explicitly how epidurals
effect breastfeeding...because there is no such answer. What we have is
anecdotal for the most part.

I think that a scientific answer will be a long time coming because
there are so many variations of epidurals, length of epidural admin.,
what meds are used etc..... I have discussed this at length with a very
sympathetic nurse anesthetist in our institution.

I realize this won't help you with your doc friend but....what I tell my
CBE clients is...probably best not to have one, but if you are going to,
get it as late and as light as possible. This implies that they will
need good labor coping techniques to get to a stage where it would be
"safer" and less likely to have time to cross into the blood of the mom
and hence thwe baby.

You might want to talk to Tom Hale on this. I know he is doing a
presentation on it next month somewhere in Virginia....I don't have the
mailing I received anymore.

Tom  spoke on the topic in Cincy a few years back and essentially said:
We don't know that it effects breastfeeding....on the other hand we
don't know that it doesn't. Best to err on the side of protecting the
baby. (please don't quote this, it is a rough paraphrase...go to the
source!)

Hope you get what you're looking for and, by the way, if you do find
something difinitive...plz. post to lactnet so we can all benefit!

Susan Keith-Hergert RN, MS, CPN, IBCLC

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