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Is postnatal depletion a thing, or is Gwyneth Paltrow just trying to sell vitamins?
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The term "postnatal depletion" is popping up on mom blogs because of an article on Gwyneth Paltrow's wellness website, Goop. Is this a real condition, or is the Hollywood star trying to sell tired moms vitamins? - photo by Jennifer Graham
The term "postnatal depletion" is popping up on mom blogs lately because of an interview with an Australian physician published on Goop, a popular wellness website run by Hollywood star Gwyneth Paltrow.

In the article and a forthcoming book, Dr. Oscar Serrallach contends that pregnancy shrinks the brain and depletes a woman's body of essential nutrients for up to seven years. He believes that up to half of all moms experience the symptoms of postnatal depletion, which he says include fatigue, anxiety, brain fog and loss of libido.

Not by accident, next to the interview is an advertisement for a regimen of Goop vitamins designed by Serrallach and tailored for new moms. "The Mother Load" costs $90 for a one-month supply.

Is postnatal depletion a real condition, like postnatal depression? Or are Paltrow and Serrallach taking advantage of tired moms by selling them vitamins?

The Goop empire is growing, despite savage criticism from some doctors who say that some of its advice and products border on dangerous. Here's a look at why Goop is under fire and what its website says about the health of new mothers.

The message of Goop

Maternal depletion is a condition debated since at least the 1980s when a pair of researchers published a paper called "The maternal depletion syndrome: clinical diagnosis or eco-demographic condition?"

The term is sometimes used as a catch-all to explain the poor health of a mother and child when other diagnoses are not apparent. Not everyone in medicine believes that maternal depletion syndrome is an actual condition; some say that nutritional deficiencies and having other children in rapid sucession are to blame, particularly in developing countries.

The depleted mothers in developing countries, however, are likely not reading Goop.

Launched in 2008 by the star of "Iron Man" and "Shakespeare in Love," Goop is a lifestyle enterprise that caters to American women who don't struggle to pay their bills. The brand has been called "organic-luxe," and the website's average reader is 34 years old with a household income above $100,000, according to Adweek.

In addition to publishing articles on subjects such as mindfulness, fitness and nutrition, Goop sells things. It has its own brand of skin care, fragrance and clothing, and sells clothing and shoes from other manufacturers' lines.

It recently held a wellness summit in Los Angeles. Writer Lindy West attended it for the U.K. newspaper The Guardian and said the overarching theme was that women should take better care of themselves, which is the gist of Goop's message about postnatal depletion. It's common sense that mothers need to be healthy and energetic to take care of a growing family, but it becomes one when the message is accompanied by ads for expensive vitamins and supplements to treat a condition the medical community doesn't agree exists.

Goop has been accused of inventing diseases before as a way to sell products, as when it promoted vitamins for "adrenal fatigue," which a report in the peer-reviewed journal BCM Endrocrine Disorders says does not exist.

But for many exhausted mothers struggling to balance their needs with that of their families, the idea of postnatal depletion may ring true, because depleted is what they feel every day. Paltrow says she has been there herself.

Reasons for depletion

Paltrow is the mother of Apple and Moses, children she had with musician Chris Martin before their divorce, which she famously called a "conscious uncoupling."

She also had a miscarriage that she has said nearly killed her. She told People magazine earlier this year that she has struggled with physical depletion since becoming a mother 12 years ago.

When my kids were younger, I put them first to the point where I exhausted myself. It led to me being short-tempered, she said.

On Goops website, Serrallach explains what could be the reason Paltrow was short-tempered postnatal depletion, which he says causes fatigue (even if youve had a good nights sleep), hyper-vigilance, low self-esteem and frustration, brain fog and what Serrallach calls emotional lability emotions that change quickly.

Postpartum depression, which is thought to affect 10 to 15 percent of women after giving birth, is the most severe form of postnatal depletion, Serrallach says.

The American College of Obstetricians and Gynecologists says postpartum depression is marked by persistent feelings of sadness, anxiety and despair and that it is caused by a combination of fluctuating hormones, fatigue, lack of support, mixed feelings about motherhood, and for some women a history of depression.

Serrallach says postnatal depletion is the result of the developing baby sapping nutrients and energy from the mom.

"The placenta serves two masters: the growing baby and the mother," he says in the Goop interview.

"During the pregnancy, the mother supplies everything that the growing baby needs, hence why so many mothers become low in iron, zinc, vitamin B12, vitamin B9, iodine and selenium. They also have much lower reserves in important omega 3 fats like DHA and specific amino acids from protein," Serrallach said.

Serrallach also said that a woman's brain shrinks about 5 percent during pregnancy, a phenomenon that is thought to be related to a mother becoming in tune with her baby's needs after birth. A study published last year in the journal Nature Neuroscience suggested that the change is a form of pruning that makes a mother more emotionally responsive to her child.

Serrallach also says that societal changes including the fact that some women are delaying having children until their 30s are making pregnancy and motherhood physically harder on women, which is compounded by having multiple children in a relatively short time.

"As a society we tend not to allow mothers to fully recover after childbirth before getting pregnant again. It is not uncommon to see the phenomenon of a mother giving birth to two children from separate pregnancies in the same calendar year. Also with assisted reproduction we are seeing higher rates of twins, which will obviously exacerbate any depletion," he said.

Maybe it's normal to be tired?

While many mothers of multiple children are tired, that doesn't necessarily mean there's something wrong with them. Weariness, like pain, can just be the body signaling that it's time to take a break.

Critics of Goop say that Paltrow and Co. are creating diseases out of conditions that don't exist, or, if they do, don't require vitamins as much as a week's worth of groceries. Dr. Jen Gunter, an ob-gyn in San Francisco, says that the Goop website is a "scare factory" that considers everything toxic except for alcohol (promoted on the site as good for you) and Botox, which actually are toxins.

"No, we dont have adrenal fatigue; we have goopitis," Gunter writes in one of her scathing criticisms of Goop's advice.

In an interview about her anti-Goop crusade, Gunter told a reporter for The Toronto Star, The Goop stuff really caught on, I guess, because there werent really any doctors countering it. Theres all these people online talking about health but theres very little good information from physicians that patients can turn to.

That's starting to change, as other people weigh in critically on some of the practices Goop advocates. The website Bad Science Debunked has called Goop a "poorly disguised pseudoscientific version of Amazon.com" and Business Insider published "7 Terrible Health Tips from Gwyneth Paltrow."

Forbes published a takedown of Goop's advice for women to take iodine supplements, noting that the "expert" who gave the advice advertises himself as a "medical medium" who converses with a "high-level spirit who provides him with extraordinarily accurate health information thats often far ahead of its time."

There's even a book that challenges Paltrow's authority as a health expert: "Is Gwyneth Paltrow Wrong About Everything? When Celebrity Culture and Science Clash" by Timothy Caulfield.

As for postnatal depletion, it appears to be a term if not coined, at least popularized, by Goop and Serrallach, who has a book coming out on the topic in 2018. Like adrenal fatigue, postnatal depletion is "medically unrecognized," Stassa Edwards wrote in Jezebel.

But that doesn't mean overworked mothers don't feel depleted and grateful that there's a conversation going on about the physical challenges of motherhood.

So what's the solution?

Serrallach says that depleted mothers can restore themselves by focusing on four things: sleep, purpose, activity and nutrition. This doesn't just mean that women should start eating more healthful foods; he suggests that moms go to their doctors (or "functional health practictioner") and be tested for nutritional and hormone deficiencies.

Serrallach says all women who have recently given birth should be getting omega 3 fatty acids, either through food or supplements. (And, not surprisingly, think about buying some "good-quality" vitamins and herbs.)

He also recommends that new mothers focus on "optimizing" their sleep, physical activity and relationships. And he urges women to think about motherhood as a "heroine's journey" and an important part of their self-actualization, the psychological journey that became popularized when the late psychologist Abraham Maslow put forth his "hierarchy of needs."

But other people need to help, too, and this is advice any mother can use whether she feels depleted or energized by the experience of being a mother.

"Get support, get support, get support," Serrallach says. "You cant have too much support (and a baby sitter is a lot cheaper than a divorce)."
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