Birth is a significant life event and generally a happy one. Although labor is often challenging, it can also be empowering, with mothers experiencing elation and strength. Unfortunately, for other women, birth can be difficult, can be overwhelming, and can lead to psychological trauma. Some women may experience depression and posttraumatic stress disorder (PTSD) following their births. These effects can last for years and can cause difficulties in women’s relationships with their partners and their babies. Difficult births can also negatively affect breastfeeding. This article describes the prevalence of PTSD after childbirth and summarizes the symptoms so that International Board Certified Lactation Consultants (IBCLCs) can help recognize it and refer mothers to appropriate resources.

Introduction: Metoclopramide and domperidone are medications that block dopamine receptors on the lactotrophs, allowing prolactin levels to rise. Both medications are prescribed to boost milk production in mothers with low milk production due to hypoprolactinemia. The Food and Drug Administration has not approved the use of domperidone in the U.S. because of concerns about increased risk of cardiac arrhythmias. Metoclopramide is often recommended instead. Unfortunately, metoclopramide affects the central nervous system (CNS) and increases the risk of both depression and tardive dyskinesia (TD).

Method: The present study is an online survey of self-reported side effects of 1,990 mothers, representing 25 countries, who took metoclopramide, domperidone, or both medications to enhance milk production. Data were collected in 2010.

Results: The results indicated that side effects, in general, affected only a small percentage of women who took either medication. Women were 3.6 times more likely to report no side effects when taking domperidone vs. metoclopramide. There were no significant differences in cardiac arrhythmias for women who took metoclopramide versus domperidone. Racing heart was more common with metoclopramide. Less than 1% reported these symptoms in both groups. However, CNS effects were significantly more common in women who took metoclopramide. Risk of depression increased by seven times, and symptoms of TD (tremors, involuntary grimaces, and jerking) increased by 4 to 19 times when women took metoclopramide.

Discussion: The results of the present study are preliminary, but suggest that cardiac arrhythmias are a rare side effect with both medications. The CNS side effects with metoclopramide are more concerning, particularly depression and TD. It is hoped that the recommendations regarding the relative safety of these medications will be re-examined in light of these findings.

Overview: Bedsharing is common in the United States in spite of numerous public health campaigns telling parents not to do it. This suggests that generic, never-bedshare messaging does not result in safe-sleep behavior. It also suggests we know little about the characteristics of mothers who bedshare. This study addresses this gap by examining demographic characteristics of mothers including race/ethnicity, income, education, partner status, and maternal age.

Sample: The sample was the U.S. cohort (N = 4,789) of the Survey of Mothers’ Sleep and Fatigue.

Results: Consistent with previous findings, we found that African American and American Indian mothers were more likely to bedshare, as were lower income and single mothers. We also found that bedsharing mothers were more likely to have lower education levels, be younger age at first birth, and were less likely to be currently employed. There were also striking racial/ethnic differences on location of night feeds, where mothers think babies should sleep, and their reasons for engaging in their nighttime parenting practices.

Conclusion: Our findings suggest that the mothers’ demographics are related to bedsharing practices. Furthermore, simply describing bedsharing in terms of “cultural differences” oversimplifies a complex set of behaviors and beliefs. Safe sleep messaging, including safe bedsharing, needs to be tailored to address the various subgroups of mothers living in the United States.

The increase in breastfeeding rates in the African American community is largely due to the efforts of several grassroots organizations. This article briefly describes some of these organizations, highlighting their objectives, mission, founders, and beginnings.