Hypothryoidism and Milk Let Down

[welshwife08]

Ladies,

I need your help! My DS is 10 days old and we are having some milk supply issues. Today, the leader of my local LLL (who is also a lactation consultant at the hospital) came to my house to check up on me and see how DS and I are doing.

She has told me that my milk is not letting down. As a first time mom, I would have no idea, so I didn't know there was a problem. DS is hungry all the time (like 1.5-2 hours), but I thought that was part of being a newborn. He is still producing wet and dirty diapers, but has not gained any weight since leaving the hospital (he has did lose some weight, but he is not back up to his birth weight). He has a great latch-on and sucks like a champ. She has recommended that I see an endocrinologist to make sure that everything is ok with my thyroid. She believes that my thyroid is inhibiting my body's ability to produce oxytocin and, therefore, inhibiting let down.

Anyone have any experience with this? She even recommended I supplement with formula! She said she couldn't believe that she was recommending that as a lactation consultant AND a LLL leader, so I am guessing this problem is fairly uncommon.

I'm pretty upset with myself. I tried to nurse DS about an hour ago and just started crying and telling him over and over that I was sorry, so obviously postpartum hormones are playing their part in all of this as well.

Thank you for any help you can provide!

[PatioGardener]

And congratulations on your new baby!

How many heavy wet diapers does your baby have in 24 hours? What about poops? At 10 days old we would expect 6 heavy wet diapers in 24 hours, and more than 3 poops (yellow, maybe seedy) in the same time frame.
ETA: if baby is not making enough wet diapers it is very concerning and a reason to seek medical help quickly.

Not gaining any weight since leaving the hospital is worrying - but the answer is to make sure that baby is latched and transferring milk well! And if you need to supplement, the first step would be to recommend that you pump/express your own milk and give that to baby. Was there any reason she didn't recommend that? Have you tried to pump or hand express?

Hypo and hyperthyroidism can affect supply. Do you have a history of such a medical issue? There are some cases of severe anemia affecting supply too, as well as pituitary issues (where the milk hormone, prolactin is produced) and PCOS. For a baby who is not gaining well but seems to have a good latch and milk transfer (no tongue tie) I think a medical assessment of mom and baby is a good idea, but I would think it is well beyond a LLL leader or IBCLC's scope of practice to diagnose a medical condition!!!

I would recommend seeing baby's doctor about the lack of weight gain, and looking into milk transfer, latch and supply some more. If baby needs supplementation (and to increase your supply) you could try pumping after feeds and feeding that milk with a spoon, tube, syringe or bottle (I always worry about bottle preference so prefer the tube at the breast).

Maybe there was an immediate need to supplement baby and that is why she recommended formula (dehydration, drastic weight loss etc). If not, you may want to look for someone who is more supportive of breastfeeding.

[Bokonon]

I agree with PatioGardener - were test weights done to determine that you are not letting down? Feeding every 1.5-2 hours is completely normal. My baby was doing this until 6 months old, and I have a perfectly ample supply!

[Blueone]

I have hypothyroidism. We were feeding every 15 minutes, then we'd have block feeds that lasted 5 hours. I have to say, feeding every 1.5 hour to 2 hours seems normal.

We had so many other problems and he wasn't gaining weight or putting out enough diapers so we had to stop. It also caused a lot of depression for me. So saving my sanity was also part of the reason.

Are you on the right dose for thyroid meds? Sometimes you need a raise after having a baby. My levels had plummeted after giving birth, now 8 months later I'm finally on the right medication dose.

How about doing anything to help encourage let down? Sometimes you have to relax and take a deep breath and just clear your mind. Breast compression and massaging also helps.

Good luck!

[welshwife08]

Thank you for your replies!!

I have hypothyroidism and have been on meds for a couple of years. I had to have my dose adjusted once during pregnancy

1. Yes, weight tests were done. He gained about an ounce and a half. She did say that I was right on the cusp of producing enough milk and not to give up. She recommended that I call my OB about possibly prescribing an oxytocin spray to encourage let down and to definitely call the pediatrician.

2. DS has had enough wet and dirty diapers (7 wet--I wouldn't say they were heavy but they weren't light, 5 dirty but output on dirty was small for 3 of them), so right now I am not concerned about dehydration. The no weight gain IS a concern.

3. I was thinking that every 2 hours, while EXHAUSTING, is pretty common. It just seems like he isn't getting enough to satisfy him.

We did supplement today before putting him to bed with 1 ounce of formula with a syringe. I tried pumping and got less that half an ounce. The difference in bedtime when he is apparently full is amazing. He went down without any struggle and has been sleeping peacefully. I'm at least grateful for that! My nerves and my emotions are still pretty raw and a good night's sleep is what I need right now (probably should stay off the internet then, but oh well).

I will be calling my doctor, the pediatrician, and an endocrinologist that she recommended tomorrow so I can get this sorted out as quickly as possible.

[Xavismom]

I have hypothyroidism too. Just wanted to give you some support and encouragement Mama! Sounds like you are on the right track, and seeing an endocrinoligist is definately a great idea.

My DS nurses about every 2 hours, and has from the get-go. It is a lot of nursing! He really chunked up around 2 months (14.5 pounds) He is still nursing that often at 4 months.

Good luck!