NEWBORN:
1. If FM or CFIDS inheritable? Do you find many parents worried about that?
A -- although approximately half of my patients have a family member with CFS/fibromyalgia, the risk of any one individual child getting it is low because we have so many family members. This reassurance is very helpful for the parents. In addition, regardless of the popular misconception, fairly effective treatment has shown to be available for fibromyalgia -- as demonstrated in my placebo-controlled study. (I would note that the journal of the American academy of pain management -- one of the largest multidisciplinary societies of pain specialists in the U.S. -- had an editorial noting that our treatment protocol is "an excellent and highly effective part of the standard of practice for treating fibromyalgia and myofascial pain syndrome.)
2. Should moms with FM breastfeed? Are there the same restrictions on meds? Is it too tiring to breastfeed?
A -- I generally apply the same principles to breast-feeding as being pregnant. If possible, I have the Mother breast-feed for at least six months and avoid the same medications that were avoided during pregnancy. I do not think it is too tiring to breast-feed and breast-feeding also helps with weight loss -- which is emotionally important to the patient as well (while also decreasing the risk of sleep apnea). It is, of course, also very healthy for the baby. It is critical however that the Mother stay on her nutritional regimen while breast-feeding.
3. Is the severity or incidence of postpartum depression worse in moms with FM?
A -- if adequate support is given with fish oils and progesterone, postpartum depression seems to be less common.

WRAP-UP:
Do you have any other advice for women concerning pregnancy and fibromyalgia?
A -- be sure that thyroid hormone levels are adjusted to the level that feels optimal while keeping the free T4 within the normal range. Otherwise, the information in the top 10 tips for pregnancy article apply .

Also, feel free to call or e-mail with any questions that come up in general. I do have 2 day workshops for practitioners that I give in Annapolis MD and Los Angeles, and tapes of these workshops are also available. If you have not seen our published double-blind study, the full text can be seen at www.endfatigue.com . Thank you for your caring and concern for these patients!
Jacob