Joanna Koch posted:

>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 don't have expertise in designing studies, but I wonder whether a 
prospective approach might be the way to go, rather than doing a 
case-control study. It should be possible to gather background 
information before birth (e.g., birth plans, feeding plans), ask moms 
to fill out one or more follow-up surveys after birth (e.g., birth 
experience, breastfeeding), and churn the data through some 
statistical analyses.

Um, yeah, churn. Did I mention I'm not an expert? ;-)

I do know, however, that the design is viable for some research 
questions. For example, I just wrote an article on a study exploring 
whether there's a link between alcohol consumption during pregnancy 
and male newborns' risk of cryptorchidism. Obviously, it'd be totally 
unethical to use a case-control approach here!

The researchers in this study gathered data through prenatal and 
postnatal surveys, did their analyses, and made some conclusions. 
This study involved more than one site, too. Employing a multicenter 
approach for a prospective epidural and breastfeeding study might 
garner enough non-epidural participants for statistical power.

Funding though. Who's going to ante up?

Just thinking aloud.

regards,
Julia

Julia R. Barrett
Freelance Science Writer & Editor
Mom to Sean (6) and Kira (3)
Madison, Wisconsin 

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