I doubt we'll ever get to the bottom of just what impact an epidural has on
breastfeeding.  Too many variables - and how do you do a really good study?
Can you imagine recruiting mothers to have unmedicated deliveries so that
you had a control against which to compare?  When epidural rates are in the
90 percent range, as they are locally, you're not going to find that
population!  I agree with the comment that those moms who choose unmedicated
deliveries tend to be those more likely to persevere with breastfeeding and
understand the disadvantages of formula feeding.

Anyway - my comment is that 20 years ago (when I first started counseling
breastfeeding moms) I did not meet many confused babies.  Am not sure I can
recall any in fact.  My feeling is that the percent of disorganized feeders
has increased in direct relationship to the increase in epidural rate.  20
years ago was the tail end of the natural childbirth movement - remember
lamaze?  Now we're fully into managed labors, at the request of the mothers.
My humble opinion is many of them are paying for snoozing thru labor with
weeks of difficulty with bfdg.

Great example - a physician had 2nd child and demanded painfree labor.  Her
buddy, the anesthesiologist, had trouble with the epidural.  One of those
moments where more and more med was pushed into mom but w/o adequate pain
relief.  You can imagine how much was given as this loud and demanding
physician berated the poor man.  Anyway - guess what happened with her baby.
Of course.  Took him 6 full weeks to snap out of it and breastfeed with
vigor.  He looked as if he was tripping the first few weeks.  Mom was
furious he couldn't breastfeed like her first.  I hoped she'd become an
evangelist for less epidural but, silly me.

Joanna Koch, IBCLC, N Ca  

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