In a message dated 96-07-06 14:09:02 EDT, you write:

>Subject: BF and " walking epidurals"
>
>We've been using walking epidurals (Intrathecals) for probably close to 3
>years.  We have never had epidurals so I'm unable to compare with this type
>of medication.  Generally the meds are given a little later in labor here
>(4-6cm), but this varies a lot.  The moms generally recieve one dose of
>medication, they aren't confined to bed and they don't recieve the large
>bolus of fluids that moms with epidurals recieve.  I can't say that I've
seen
>any problems with breastfeeding other then some sleepy babies in the first
24
>hrs.

I, too have been interested in the difference between intrathecals and
epidurals and the effects on breastfeeding.  I have, 2 years ago, or so,
switched jobs from a small Catholic hospital, with 1500-2000 deliveries a
year,  to a large Catholic hospital (4000 deliveries per year).  In the small
hospital women were given epidurals at 4-5 cm when I first started working
there, but this "rule"was relaxed and they were allowed to get them earlier
in more recent years.  They were given by nurse anesthesists (sp?), were
mainly narcotic mixtures (they called it the "cocktail") and were allowed to
wear off prior to pushing.  At the large hospital women get continuous
 infusions for the most part bupivicaine with occasional lidocaine redoses
and fentanyl thrown in now and then.  They also use xylocaine on occasion.
 The epidurals are given right up to delivery and women are often redosed
several times.  The epidurals are given by anesthesiologists--several of them
take turns, it appears to be very lucrative, and so they have had to divide
the wealth.  Each of them has their favorite concoction.
Anyway, I have seen a difference in breastfed babies in the two hospitals. At
my present hospital I have seen a lot more sucking problems--babies who suck
their tongues, uncoordinated suck, etc.  We also have a lot of babies who are
very sleepy and difficult to arouse.  I see a lot of babies who do not
root--I would have to say that is different, also.  The sleepiness was
present at the first hospital (with the narcotic epidurals), but I do not
remember seeing the numbers of babies with sucking problems--tongue sucking,
especially.
There are variables--mainly the length of time that epidurals were given.
 But the other variables, like pitocin use, planned inductions, vacuum
extractions are pretty much constant, from what I've seen.  Both hospitals
remove babies from their mothers to weigh, measure, shoot with Vit K before
breastfeeding is given a chance.  It is very sad.  Not a very scientific
comparison, but I do see differences.
It was interesting--I recently attended Lactation Associates workshop on
sucking problems, and some of the abnormal reflexes and problems with state
arousal that are generally associated with neurological insults, are problems
( however long they last)  that we see in our epidural babies.
 I have seen a few babies who can't bottle feed either.  I suppose if this
were more common, we might see some action on it.

Does anyone else see problems with tongue sucking and no rooting?
Chris Lundberg
Indianapolis, IN
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