The Weblog of Cynthia Good Mojab

I’ll be giving three presentations at La Leche League of Oregon’s Conference for Families and Health Care Professionals on November 11-13, 2006, at the Hilton-Eugene in Eugene, Oregon. In my presentation, “Postpartum Depression: The Most Common Complication of Birth,” I will give an overview of postpartum depression, how breastfeeding and postpartum depression interact, how and why to screen and refer breastfeeding mothers for treatment, and how to protect breastfeeding in the context of treatment for postpartum depression. In “The Hot Topic of Infant Feeding Rhetoric: Risks or Benefits?” I will explore the multidisciplinary evidence base that provides guidelines on identifying and using effective and ethical language when communicating about infant feeding, particularly whether to speak of the “benefits of breastfeeding” or the “risks of formula feeding.” In “Pioneer Mothering” I will talk about the challenges that many contemporary women courageously face as they mother in a markedly different way than has been done in recent generations, for example by being the first mother for generations in her family to breastfeed. The conference is geared to meet the needs of families, health care providers, and mental health practitioners. Health care professionals can earn continuing education credits for attending two of my presentations, as well as for attending many other presentations at the conference. For more information about my private practice, speaking engagements, and publications, see my website at http://www.lifecirclecc.com. For general conference and registration information, see the conference website http://www.llloregon.org, call 503-824-5533, or email info@llloregon.org.

Last night I participated in The Birth Tour in Portland, Oregon (http://www.thinairmedia.org/birthtour.html). What a gathering it was! Perhaps 20 or 25 adults, mostly women–and a few men as well as several babies and young children. The smaller size perhaps contributed to the ability of participants to share in a more vulnerable and genuine way than is commonly found among strangers.

We did not feel like strangers for long. When the gathering was over, most of us felt like we could have talked for several more hours. The topic of birth is compelling. Whether we yearn to give birth, grieve the loss of a stillborn child, celebrate a well-supported home birth, struggle to come to terms with a traumatic birth, or choose not to give birth–we all are united by the ordinary and extraordinary experience of being born. No one is untouched by birth.

In many circumstances, the topic of birth is taboo–birth as it really is, with all the soul-nourishing empowerment and soul-crushing disempowerment that different birth experiences can entail. However, given the right setting–one in which we truly feel heard and respected–many of us feel the urge to tell our stories. We seem to have a human need to celebrate with others the joy of birth and to also grieve its sorrows. We need others to bear witness, to laugh with us and to cry with us, and, perhaps more imporantly, to just to be with us while we laugh and cry. With the acceptance and validation that can come with such companionship we seem better able to find and create meaning and healing in a way that we cannot do alone. This companionship is not always easy to find–especially when we are grieving the loss of an expected birth experience. “Focus on the baby,” we are told, “That’s all that really matters.” But any sorrow and anger that a woman may feel in regard to her birth experience do not in any way negate her love and gratitude for her baby. Just as the baby matters, so does a woman’s experience of birth. I hope that one day all women will have the companionship and support that they need and deserve as they experience the life-altering experiences of pregnancy, labor, and birth.

Cynthia Good Mojab, MS, IBCLC, RLC, CATSM

I have been thinking today about the fullness of the experience of mothering. Women may celebrate the privilege of mothering their children in one moment and feel overwhelmed, overworked, and full of frustration in the next. We feel gratitude for our children even as we grieve the loss of our former lives and former selves. Motherhood may involve great joy and great sorrow. We watch our children grow and learn. Through their eyes, we see anew the beauty of the world around us. Their ability to grow and change and become who they must become is awe inspiring. We take pride in growing and learning right along with our children. At the same time, we grieve being unable to conceive, the loss of a baby during pregnancy, the stillbirth of a baby, the death of a child of any age. We grieve the loss of expected experiences–be they related to conception, pregnancy, birth, adoption, breastfeeding, or mothering. We struggle to come to some kind of terms with a congenital disorder in a child. We struggle to overcome postpartum depression right when we expected to be very tired from mothering a newborn–but still happy. The fullness of the mothering experience is often insufficiently acknowledged, leaving many mothers wondering if they are the only ones having very mixed feelings about a very mixed experience. May your Mother’s Day have offered you the chance to honor your experience of mothering in a deeper way, knowing that a full spectrum of feelings is a normal and healthy response to a full spectrum of experience.

Cynthia Good Mojab, MS, IBCLC, RLC, CATSM

Thyroid dysfunction can negatively impact both maternal mood and breastfeeding. Therefore, whenever a new mother is experiencing symptoms of depression and/or low milk supply or low infant weight gain, assessment of her thyroid function is warranted. High levels of thyroid stimulating hormone (TSH) and low levels of triiodothyronine (T3)/tetra-iodothyronine (thyroxine or T4) are suggestive of hypothyroidism. Thyroid replacement therapy may alleviate both symptoms of depression and low milk supply. Low levels of TSH and increased levels of T3/T4 are suggestive of hyperthyroidism. When either hypo- or hyperthyroidism are present, treatment and techniques that facilitate milk release may be helpful: pitocin nasal spray for milk ejection, breast massage from the chest toward the nipple, and breast compression during breastfeeding.

Reference: Marasco, L. The impact of thyroid dysfunction on lactation. Breastfeeding Abstracts 2006; 25(2):9, 11-12.

Cynthia Good Mojab, MS, IBCLC, RLC, CATSM

The World Health Organization  has issued new guidelines on the growth and development of babies. Using a worldwide sample of over 8,000 children from six countries, the studies show how children grow when they are exclusively breastfed for six months and continue to be breastfed after the introduction of appropriate table foods and drinks. Only breastfed children were included in the study. The new WHO Child Growth Standards are based on data from Brazil, Ghana, India, Norway, Oman and the United States. Prior growth charts were based on formula-fed children, who grow differently than breastfed children. For the first time, these new charts allow the comparision of an individual breastfed child’s growth pattern to growth norms based on breastfeeding. The new growth charts may be accessed at: http://www.who.int/childgrowth/standards/en/

Cynthia Good Mojab, MS, IBCLC, RLC, CATSM

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Cynthia Good Mojab, MS, IBCLC, RLC, CATSM