Dear Ellen:

I can understand that you have fears and concerns about the normal pain of childbirth. You must consider all your options. For any action you take there is a possible reaction.

Any medication you take or are injected with during labor has a possibility of crossing over to the baby. This may not cause any long term harm to the infant, but most meds moms get do cross over to the baby can have the possibility of dulling the baby's natural instinct to nurse properly (sometimes for an extended period.)

Epidural use in the breastfeeding community has become a very hot topic. What you have to do is become an informed consumer about all aspects positive and negative of epidurals before you go into labor. The side effects noted can and do vary greatly by what medications are in the epidural and the amount of time mom has the epidural.

Some thoughts -- there seems to be a significant increase to birth interventions when epidurals are used -- vacuum extraction, forceps,  drop in mom's blood pressure, possible loss of ones ability to push, the use of pitocin, failure to progress and c -section delivery. Not all of these possible interventions or side effects would happen to you but some or all could, so do your homework.

So for your "pain free" delivery you need to check out every side of the story, not just your doctor's or the anesthetist who gives the medication. You are the consumer you have a right to know all sides of the story. There are a large number of non drug means to help control/direct the pain of labor. Ask your child birth instructor or your midwife if you are not delivering with a ob or family practice doctor.

Notes from my practice: In the last 5+ years I have seen a huge increase in babies that are having a much slower time getting started nursing (up to over 2 weeks) for no apparent reason. One common denominator in this group of babies is very lazy and mostly uncoordinated sucking patterns -- seems that the mom had an epidural for longer than 2 hours and / or Fentanyl or Bupivcaine were in it (there are a couple of other meds, but these seem to be the worst.)

There is more clinical research data coming out all the time to verify what I and other lactation consultants are seeing in their practices. Most of these babies seem to have a harder time getting started nursing. So you have to make your own choice on whether to have epidural or not -- will it cause long term harm to the baby -- probably not -- could it affect the baby's ability to get started nursing well -- seems very possible depending on the medications used and the time you have the epidural before delivery. So you could have a very pleasant delivery and possibly a rougher start in your nursing relationship with your baby.

Good luck in your information search (and birth). You are going to be a great mom. By taking the time now to get additional information means you will do the same after the baby is born and everyone will benefit.

Sincerely,

Anne Norton-Krawciw,RPh, IBCLC
Lactation Consultant - Pharmacist

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