What you have to remember is that the alternative to an epidural infusion with or without patient controlled anesthesia is some form of narcotics anyway, just going in via a different route and one that is going to make the mother very sleepy - the kind of sleepy where you can actually drop your baby (I've seen it happen), can't focus on breastfeeding, can't walk very well... very disruptive to all the work that a new mom and baby need to do together over the first couple of days. When I worked on the floor as an OB nurse I always felt very disappointed for moms who missed the opportunity to have epidural anesthesia after their c-sections. It was remarkable how fast the women who had epidurals were able to get out of bed and start moving around comfortably and coherently less than 24 hours after having major surgery.In our hosptial they use an epidural infusion of fentanyl, which has very low transfer into milk and very poor oral bioavailablity, so the tiny amounts that get into milk are I think pretty much knocked out in the infants' belly.(Hale rates it an L2 with no adverse effects reported via milk, though he seems to be discussing IV admin, not epidural) We used Duramorph in the past but the women were scratching themselves into a frenzy and its duration was unpredictable. In our hospital women usually get coverage with epidurals for 48 hours after surgery at which point they are able to take painkillers by mouth (usally Percocet) which is much less disruptive than IV narcotics, and they have made it through the two worst days of pain following surgery with their wits about them and relatively little pain. Kathy Lilleskov RN IBCLC *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome