The Epidural Question

I was having dinner with a lactation consultant, who’s been working
in the field for over ten years. We got to talking about how many more moms she’s seeing who just aren’t producing enough milk.  She’s convinced, as are other researchers, that epidurals play a part in this. I’ve been looking at this question too, and the literature suggests there are several things associated with “sub-optimal breastfeeding” and infant weight loss. 

One thing that just pops out of the literature and is most highly associated with sub-optimal and delayed breastfeeding is flat and inverted nipples.  There’s no question flat and inverted nipples are
absolutely associated with inability to breastfeed the way you want.  And that makes the use of pumped milk and/or formula necessary.

Here’s what I do. During the first prenatal visit, I check the mom’s nipples.  If she’s inverted or flat, I give her Swedish milk cups to help her get those nipples to pop out.  I also recheck again at 34 weeks so that if the nipples have become flat as the breasts grow, we can start the milk cups then.  For those of you who haven’t seen the cups, they slip easily into a bra and give you that torpedo look that may or may not be attractive (I guess it depends on your perspective!).  I’m always amazed at how many adaptations we make as moms for the sake of our babies.

Back to the epidural question. The results are less clear as to whether this affects the ability to breastfeed.  There are studies that show that for new moms there is not an association, but for moms who’ve delivered at least one other baby, epidurals are associated with less than stellar breastfeeding.  Makes me wonder what else is going on and what we’ll learn as more research comes in.  Stay tuned!  I’ll be monitoring the studies.