Guest Author - Nicki Heskin
In my article "Epidurals and Breastfeeding – My Labor Experience" I outline the effects of my epidural on my labor and how it affected early breastfeeding. After what seemed like a respectable first feed, the baby lapsed into a deep sleep, while the medical staff "worked" on me – doing some post-labor steps involved in an epidural.
When I woke the baby a few hours later to attempt nursing #2, the baby wanted nothing to do with it. When I brought her to the breast, she screamed her head off. Every time I tried to nurse, she resisted and cried. I was told later that it's not uncommon for babies who have had their airways suctioned to be in some pain from the insertion of the tube and to associate that pain with nursing.
The times when she did seem willing to nurse, she was unable to latch effectively. I had pretty flat nipples at the time, and the breast shells the nurses gave me to "draw out the nipple" did nothing to help. I know now that the third spacing of fluids left in the body from the epidural made it even harder for the baby to try to latch, which causes extra problems for those with flat or inverted nipples.
The nurses weren't overly concerned as they said that babies can lose some weight in those first days while nursing is established. They also told me that it's normal for babies to be quite tired the first few days – after all, labor is hard, right? What I learned after my second baby is that it's not uncommon for babies born to mothers under epidural anesthesia to be tired for a few days after labor – with rates of 90% or higher in many hospitals, I can now see how this would come to be understood as "normal."
However, a truly *normal* baby is eager to nurse frequently in the days after birth, responding to an instinct to suckle frequently. This biological urge lines up exactly with the mother's need for frequent suckling to stimulate the milk supply to increase and to develop prolactin receptors in the breasts.
More than 24 hours before anyone realized we'd had NO successful latches or feeds and brought me a pump with instructions to give it a try. I did this a couple times, but then it was time to go home. I'd had maybe 10-15 minutes of successful pumping that did little to replace the breast stimulation from the leisurely feeds that should have occurred at least every two or three hours during that time. While my milk did transition from colostrum to mature milk at 3 days, which is fairly typical, the supply was already severely compromised and arrived with little force. We had still not worked out our latch issues sufficiently, and within days my baby was in a weight loss crisis. After many visits with our breastfeeding-supportive pediatrician and several visits with a wonderful lactation consultant, we were able to keep her on exclusive breastfeeding with heavy intervention from pump, bottle and nipple shield. By this time, I also had pretty severe nipple trauma from repeated poor latch.
Ultimately, it took 4 months to get things straightened out, but then we were able to nurse until 18 months – once things were established, it was totally worth the early struggles, but it breaks my heart knowing that I may have been able to avoid our problems all together simply by avoiding the epidural. And for that I had worried about the pain of childbirth, having now had an unmedicated labor, I'd trade the pain and stress caused by our early breastfeeding difficulties (not to mention the pain and stress of the epidural itself) for those few hours of contractions in a heartbeat.
If you are interested in considering or want to learn more about natural or unmedicated childbirth, I strongly recommend labor preparation. We used the Bradley method for our second daughter, and its lessons about the physiological course of labor as well as methods for handling labor itself were absolutely invaluable. See the link below for information on finding a Bradley instructor in your area. I also found two books to be essential reads, and give them as gifts to anyone considering natural childbirth – The Birth Book and Ina May's Guide to Childbirth (see below for links). I actually think that The Birth Book is important for anyone, regardless of childbirth plans, and Ina May is especially great for natural birthers, water birthers or home birthers.
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