In response to the comments of Betsy Riedel, I would have to say I agree.  Of course, we see unmedicated babies that don't latch and medicated babies that do.  Those anecdotal accounts are important to remind us that there is a range of behaviors we can expect to see in dyads and that it is never going to be a black or white issue.  However, the research supports that overall, unmedicated babies who are allowed immediate sts and bonding will ultimately latch on better and breastfeed exclusively for longer.  We can't ignore that research, even when faced with apparent exceptions to the rule.
   
  Certainly, giving birth naturally does not guarantee breastfeeding success.  Actually,  according to research it really doesn't tip the scales all that much toward success.  
  Meta-analysis of the studies on epidurals and breastfeeding demonstrate that having an epidural(not IV meds) does not negatively impact breastfeeding success rates. ( I didn't come up with this- got in TDH BF course!)  From this I gather that it's the immediate sts and other areas of post partum management that are more important than natural v epidural birth.
   
  And then of course, there must be many factors that contribute to whether these babes catch on to Latch On such as intrauterine elements Ms Riedel mentioned, location of birth, birth attendant, mom's nipples, tight frenulums and many more I couldn't even think of.
   
  I don't think it's an issue of it being someones fault when breastfeeding isn't going well- the point is to take action to help fix the problem quickly- not place blame.  But it is important that we don't obfuscate the risks of modern obstetrical birth interventions in terms of breastfeeding.  They can have serious, negative effects on lactation. I, too, have been a labor & delivery nurse for long enough to see much of this- unfortunately.  
   
  As an interesting side note, I believe I have read that Jack Newman recognizes that not all babies, regardless of an "ideal" birth, have a strong suckling ability and go on to easily breastfeed well.  I believe he attibutes this to a certain economy of reproduction in that not all babies are "meant" to survive (for whatever reason) and that in years gone by these babies with weak suckling capabilities would have served to limit population sizes- interesting, but of course, we work very hard to ensure this little guys overcome this!
   
  Mary Herrington RN
Labor & Delivery
St Lukes CMC
The Woodlands, Texas


   

			
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