Hi, all: I'll be testifying on behalf of the New Jersey Breastfeeding Task Force at a hearing on 5/15 about proposed return to minimum 48-hour postpartum hospital stays. The bill in question was apparently introduced by a congresswoman backed by NOW. I am highlighting factors which can aggravate breastfeeding problems failing adequate follow-up after early discharge. Among these, I wish to address anecdotal evidence of increasing numbers of babies with lethargy and uncoordinated suck-swallow related to increasing use of ever-earlier epidurals with their consequent pitocin augmentations, vacuum extractions, etc. This will likely be unpopular with the NOW contingent, who, I understand, want more epidurals! To effectively present this issue, I need documentation. Unfortunately, the literature is unhelpful, since the studies which do demonstrate postpartum problems fail to account for confounders, e.g. a higher-risk labor being more likely to result in interventions. I'm throwing this out for all your good astute observations, and any suggestions on how to present this trend (if there is one!) as a negative development. I'd appreciate international input for comparison (e.g. is there less of a problem with early discharges where epidural rates are lower?). I also have anecdotal reports that home care agencies sending home visit nurses postpartum often send nurses with no lactation training, some without maternal-child training! Having no time to call all the local home care agencies to substantiate this, I'd again appreciate any of your experiences. Thanks, Alicia. [log in to unmask]