This is my epidural bib as of June 1994:
Belsey, EM, Rosenblatt, DB. et al. The influence of maternal analgesia on
neonatal behavior: I. Pethidine. Br. J. Obstet Gynaecol, 88, 399-407.
Brazelton, TB. Effect of prenatal drugs on the behavior of the neonate. Am J
Psychiatry vol. 126, March 1970, 1261-1266.
Hattori, R. Autistic and developmental disorders after general anesthetic
delivery (letter). Lancet vol. 337, 1991, 1357-58.
Jacobson B et al. Perinatal origin of adult self-destructive behavior. Acta
Psychiatr. Scand. 1987: 76, 364-371.
Jacobson B, Nyberg K, et al. Obstetric pain medication and eventual adult
amphetamine addiction in offspring. Acta Obstet Gynecol Scand 67: 677-682,
1988.
Jacobson B, Nyberg K, et al. Opiate addiction in adult offspring through
possible imprinting after obstetric treatment. Br. Med J vol. 301, 10 Nov
190, 1067-1070.
Kraemer, H. Obstetric drugs and infant behavior: a re-evaluation. J Peds
Psych. vol. 10, 1985, 354-353.
Kron RE, Stein M, Goddard KE: Newborn sucking behavior affected by obstetric
sedation. Pediatrics 37: 1012-1016, 1966.
Kuhnert B. Obstetric medication and neonatal behavior: current
controversies. Clin Perinatal Vol 12, June 1985,423-440.
Lester BM, Als, H. and Brazelton, TB. Regional obstetric anesthesia and
newborn behavior: a reanalysis toward synergistic effects. Child development
1982, 53: 687-692.
MacArthur C, Letis M, Knox EG. Investigation of long term problems after
obstetric epidural anesthesia. British Medical Journal Vol. 304, 16 May
1992, 1279-1282.
Matthews MK. The relationship between maternal labour analgesia and delay in
the initiation of breastfeeding in healthy neonates in the early neonatal
period. Midwifery 1989: 5, 3-10.
Murray AD, Dolby RM et al. Effects of epidural anesthesia on newborns and
their mothers. Child development 1981, 52: 71-82.
Poore, M and Foster JC. Epidural and no epidural anesthesia: differences
between mothers and their experience of birth. Birth vol. 12:4, Winter 1985,
205-219.
Righard L and Alade, MO. Effect of delivery room routines on success of first
breast-feed. Lancet 1990, vol. 336, 1105-07.
Righard L and Alade MO. Sucking technique and its effect on success of
breastfeeding. Birth 19: 4, December 1992, 185-189.
Rosenblatt DB, Belsey EM, et al. The influence of maternal analgesia on
neonatal behavior: II. Epidural bupivicaine. British Journal of Obstetrics
and Gynecology April 1989, vol. 88, p. 407-413.
Scanlon JW, Ostheimer GW, et al. Neurobehavioral responses and drug
concentrations in newborns after maternal epidural anesthesia with
bupivicaine. Anesthesiology 45: 400-405, 1976.
Sepkoski CM, Lester BM, Ostheimer GW, Brazelton TB. The effect of maternal
epidural anesthesia on neonatal behavior during the first month.
Developmental Medicine and Child Neurology, 1992: 34, 1072-80.
Tronick E, Wise S, Brazelton TB, et al. Regional obstetric anesthesia and
newborn behavior: effect over the first ten days of life. Pediatrics Vol
58, no. 1, July 1976, 94-100.
Widstrom, AM, Wahlberg V, et al. Short-term effects of early suckling and
touch of the nipple on maternal behavior. Early Human Development, 21 (1990)
153-163.
NOTE: 81 mother-baby pairs were seen in my office from 4/90 to 4/93 for
assistance with complicated breastfeeding situations caused by poor sucking
responses. An informal review of the babies' charts showed:
18 (22%) had oral thrush (candida) infections
25 (31%) had abnormal, asymmetrical postures
29 (36%) had a short/tight lingual frenulum
36 (45%) were esposed to epidural anesthesia.
After eliminating tongue-tied babies, 52 remained with poor sucking response.
Of these, 28 (54%) were exposed to epidurals. The "poor sucking" seen was
not correctable with improved positioning at breast; most of these babies
also had difficulty taking oral fluids by other methods.
Linda Smith, BSE, FACCE, IBCLC
private practice, Dayton OH
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