The new article in "Anesthesiology" indicates a lower Neurologic and Adaptive Capacity Score (NACS) at 24 hr. in one group after an epidural delivery, but says, "Despite our findings, we do not believe that the differences in NACS indicate neurobehavioral depression with fentanyl that is of clinical concern... To date, no adverse long term effects have been associated with transient drug-related neurobehavioral depression." How do we request that the standards for longterm effects include infant feeding outcomes? The baby who recovers all his marbles on Day 2, but for whom breastfeeding terminates because of problems on Day 1, has most certainly suffered an "adverse long term effect" - one that researchers should be expected to address in their studies. Hmphf! Diane Wiessinger, MS, IBCLC, LLLL Ithaca, NY [log in to unmask] (Anesthesiology 83(2):300-308, 1995 Placental transfer and neonatal effects of epidural sufentanil and fentanyl administered with bupivacaine during labor. Loftus, Hill, Cohen)