Hcg levles rising but not doubling-Please help :(

[maryamb]

I am 6 weeks pregnant (as of yesterday) and still breastfeeding my 21/2 year old (only once or twice a day but still). I had a feeling that maybe my hormones were being affected because I was still breastfeeding ( I am not having any pregnancy symptoms) so four days ago I asked my midwife to check my hormone levels.  My hcg level was 5800, they did another test yesterday and it was only at 7300 :(:(:( So they are concerned that the levels did not double and are going to check my progesterone levels. 

Needless to say I am freaking out.  I am sooooooooooooooo scared.  Do these numbers seem disturbing to you?

The only two things that are giving me hope is that I didn't actually wait the full 48 hours, my first test was at 3:00 p.m. and my second was at 11:30 a.m. two days later (it was the only time I could get off work).  Would a few hours make a difference?

Also, I read that dehydration could slow down the rise of the numbers, is that true?  (I was definitely dehydrated Wednesday morning).

I am just looking for any glimpse of hope that this pregnancy will be healthy.  I feel like my heart is broken

[maryamb]

The nurse just called to say that my progesterone levels are good (17) which means breastfeeding is not interfering with my pregnancy.

However they are still concerned about the slow rising hcg levels and want an ultrasound done today.

I am a nervous wreck and can't stop crying.

[cristeen]

Honestly, I'd do a few more HCG levels before an u/s.  2 numbers don't a pattern make.  And HCG levels do not rise on a steady curve, they are slow at first, slowly increasing as pregnancy progresses.  It may or may not be an issue.  And if the numbers weren't even 2 days apart, yes that can make a difference. 

But also, I'll say that I'm almost 23 weeks, and had almost zero symptoms until well into my 2nd trimester.  Considering I had horrible m/s with both my boys, that was truly scary for me, and I couldn't believe in the pg at first.  Just keep in mind that every pg is different, and zero symptoms may just mean zero symptoms. 

[maryamb]

Thank you so much for the reply :) You are right, I should have never asked for the first test to begin with, I should have just trusted my body.  Now I have opened Pandora's box and it's an endless game of tests and worry :( I just wanted to make sure that it was safe to continue breastfeeding but definitely did not get the answer I was expecting.

I had the ultrasound earlier and they saw a sac and an embryo which measured five weeks exactly (according to my cycle it should be six weeks 2 days).  The also saw a heartbeat but the doctor was concerned that the heartbeat was only 97bpm, he said he likes to see it at around 160.  He said this pregnancy could still go either way (50/50 chance) and they'll do another ultrasound next week.

So now I have another week of worrying to do which I am sure is not helping the situation.

Has anyone else experience a weak heartbeat at five weeks?

[maryamb]

So this doctor is driving me crazy.  From the first day of my period, I am six weeks 2 days.  From the day I ovulated I am four weeks.  According to the ultrasound I am five weeks which doesn't match either one of these two days, so that's confusing.

In addition, I researched heartbeats at five to six weeks of pregnancy and the normal is range is between 90 to 103, which my baby fits right in.  This doctor told me it should be 160 which doesn't happen until 8 or 9 weeks of pregnancy.  So who's right?  The doctor or the internet?

I am seriously confused.

I considering skipping the second ultrasound, I don't think it's helping except worrying me.  Instead of being happy to see the baby on the ultrasound and hearing his heartbeat, I was crying that the it wasn't fast enough.

Can anyone tell me what their baby's heart rate was at 5/6 weeks pregnant?

[cristeen]

http://pregnancy.about.com/od/fetus/a/normal-fetal-heart-rate.htm

At about 5 weeks gestation, your baby's heart begins to beat. At this point, a normal fetal heart rate is about the same heart rate as the mother's: about 80-85 beats per minute (BPM). From this point, it will increase its rate about 3 beats per minute per day during that first month.

By the beginning of the 9th week of pregnancy, the normal fetal heart rate is an average of 175 BPM. At this point it begins a rapid deceleration to the normal fetal heart rate for the middle of the pregnancy of about 120-180 BPM.

According to that, a 6 week heartbeat should be right around 100-110, and 97 is pretty darned close, and within the margin for error.  NOT 160.  I would trust articles written by people who probably have textbooks open in front of them before a doctor who may not have looked at these numbers in years.  But that's me.  None of my textbooks seem to have fetal heart rates though, only NB, which is no help (and I can't find my embryology text). 

I would probably skip any more u/s at this point and ask for serial HCG if you're still concerned.  That will be far more telling, since as long as it's going up, it's a good sign.  At this point I'd ask to have one done on Monday and another on Thursday so you can have the results by Friday.  That should tell you more about what's going on.

HTH

[Kysmequick]

I don't want to scare you or make you feel worse, but I feel the need to share my story. After the birth of my first child (I got pregnant as soon as we started trying), I breastfed him until he was 2. In the meantime, I got pregnant again twice and miscarried twice. Actually, I had blighted ovums. The OB sent me to a fertility specialist to see what was going on.

It turned out, that after numerous tests, my breast feeding was the cause of my miscarriages. My body was just not able to handle producing milk to feed my son and maintain a pregnancy, so it ended the pregnancy by stopping progression of the fetus. The specialist explained to me that this is not the case for everyone, as there are many women who can do both perfectly well. But if your levels are not doubling as they should, maybe you should do an immediate ceasing of BF. The specialist had me put lemon or lime juice on my nipples and after 3 tries, my son decided he didn't want any more boob.

Again, I'm not trying to be a Debbie Downer, but I wanted to let you know what happened with me. I will keep you in my thoughts and prayers for a successful pregnancy.

K

[maryamb]

Thank you so much for sharing your story.  I am so sorry that you suffered through two miscarriages.  I really appreciate you telling me about your experience.

When I got pregnant my family doctor was very concerned that I was breastfeeding.  I was so confused because kellymom and and all other breastfeeding sources kept saying breastfeeding was safe during pregnancy.  But then I researched more and saw that breastfeeding could definitely affect pregnancy because the breastfeeding hormone competes with the progesterone which is needed to make the hcg hormone.  Then I freaked out and tried to stop breastfeeding and iniiated for my midwife to take the blood tests.  We have now gone down from breastfeeding four times a day to 1 time before bed, it's really hard to cut out the last one but obviously I will do it if it's putting the baby in danger.  I wish there was a sure way to know if your body is getting affected by breastfeeding or not.

How often were you breastfeeding your 2 year old?  Would you feel comfortable telling me how far along you were in your pregnancies?  I am now seven weeks (6 weeks according to the doctor).

[WaitingForKiddos]

I have to say, I have no idea how nursing would affect an early pregnancy. It's just not possible. A nursing mom's uterus is used to the hormonal releases caused by/needed for milk let down. It's not going to kick out a pregnancy that is otherwise viable. 

OP, please go and get the book Adventures in Tandem Nursing by La Leche League. There's a wealth of information in there, including studies showing no linkage between nursing and early miscarriage. I'd take LLL's studies over a doctor who likely knows little about nursing. Not to slam the doctor, it's just not in their scope of practice. The PP Dr's method of weaning alone shows their lack in understanding breastfeeding. 

I'm nursing my 18 month old son several (12+ times a day). I'm also currently 31 weeks pregnant, on bedrest for PTL caused by what seems to be a huge hemorrhage contained between the two layers of amniotic sac. Because of this I've been in and out of the hospital. ALL the ob's, perinatologists, L&D nurses, etc have said in normal pregnancies (obviously my pregnancy isn't normal) nursing will have *zero* impact on fetal health and well being. Even in my case, I was allowed to have a trail of nursing while being monitored for contractions. I had no increase in contractions even during and after a 45 minute nursing session. So I continue to nurse, nurse, nurse! 

OP, I'm going to be blunt. This pregnancy is going to stick or it's not. To me, it looks like you are having a healthy early pregnancy. That there's a heartbeat, which *is* in normal range by the way, means more than any HCG level. HCG is simply a byproduct of the placenta, not at all a level of determining healthy pregnancies. Try to take each day at a time, continue nursing your little one, and enjoy. 

[Kysmequick]

I was 8 weeks and 11 weeks. I was only nursing at night, to get my son to fall asleep. It was never for more than 15 minutes.

[Kysmequick]

WaitingForKiddos, I felt the complete same way, that's why I never stopped. I am very into breastfeeding (that's why I breastfed my son until he was 2 1/2, because my plan was to let him self-wean, but the doctor that told me was not just a doctor, she was a fertility specialist and a mother and she explained how for some women, breastfeeding while pregnant works just fine, but for some, like me, it doesn't.

I love LLL and their adamant support on breast feeding, but there opinions usually lean on the side of breastfeeding. Here's an interesting post from Babycenter that I found concerning a LLL leader's statement that nursing can possibly lead to miscarriage: http://community.babycenter.com/post/a30571049/lll_leader_stated_nursing_can_cause_miscarriage

For me, as soon as I stopped the breastfeeding and my supply dried up, my next pregnancy went full term with no issues. By no means am I knocking Moms that do both, but I say if the numbers and tests are showing a decrease in hcg levels or they aren't rising as they should, I would most definitely stop or wean.

[1babysmom]

maryamb....not sure if this helps at all, but I have nursed through 2 perfectly healthy pregnancies, and was even tandem nursing during my sons. (but I have nightweaned for each pregnancy, mostly because I get so uncomfortable in bed from the start and just don't want to deal with nursing on top of it)  However, I have also had 6 miscarriages (though 2 were prior to my first child).  That said, I do not believe that my nursing during pregnancy contributed.  I was concerned about that with my 2nd child, because I have a friend who lost 4 babies while nursing, but now that I've done it, I honestly do not feel that has been an issue (at least in my own case).  It's one of those things that I'm sure an "outsider" would say I'm only justifying because I simply place so much importance on breastfeeding and CLW'ing, but I don't think it is...I really believe it's just one of those mommy things where I just know that while there may be an issue, nursing isn't it.  I think some women and some cases may be safer NOT nursing, but for me, even with a fairly active uterus (for example, I am one of the few who can feel BH's starting early in my first trimester) I have never had reason to be overly concerned about nursing.

One thing that might be worth looking at is your thyroid, though.  Post-partum hypothyroidism can last quite a while for some women, especially while nursing, and that in turn can lower progesterone.  But hypothyroidism itself can contribute to miscarriage.  While I'm not sure if THAT was related to my losses, I do try to focus on food sources of iodine and I also have been taking Welcome Womb with this pregnancy (as well as my last one that ended in November).  But overall, I know that for me, nursing isn't something that concerns me enough to stop.

I hope that helps, and I hope that everything turns out well for you!

[maryamb]

Thank you both for replying to me.  I am now a complete mess.  I continued breastfeeding with much guilt.  Everytime I felt guilty that I was harming the unborn  baby while trying to reassure myself that everything would be ok.  We nurse only twice a day max and limit it to five minutes at a time, obviously this means a lot to my son which is why it's so hard to stop.

I just got my physical results back from my primary doctor which was taken at 6 or 7 weeks.  It showed my progesterone levels at 17.6 and she was very concerned that they did not rise and she said they should be in the mid twenties.  She wants to put me on progesterone meds as soon as possible but doesn't want to do it without approval from my midwife.  I am waiting to hear back from the midwife.  She said I am still at high risk for miscarriage.  I did not tell her I am still nursing.

Now I am wondering if it was really the nursing that made the progesterone stay constant. 

To top it off, I am prediabetic which is shocking considering I am on the paleo diet and don't eat any grains or sugar.  My blood sugar levels were high (95) and my insulin levels low (3.5).  This makes absolutely no sense to me.  My cholestorol was low including my good cholesterol.  I am also anemic.  She said all of these could affect your progesterone levels.   I am so confused but I think maybe it's time to stop breastfeeding until at least I know this pregnancy will be ok.  Given about all of the health issues that I found out today, I am seriously concerned about the health of the baby. 

[maryamb]

Talked to my midwife last night.  She said that my progesterone levels are low but not too low that should be disturbing.  She said she normally doesn't prescribe progesterone unless it's below 12 but she would do it for me if it would make me feel better.  I decided to move forward just for piece of mind.

She also said that I should have gone for the second ultrasound so they could have seen the growth of the baby (I canceled it).  She would like to do another ultrasound tomorrow at my scheduled appointment to see how things are progressing.  She also said that at this point, it's a good idea for me to stop breastfeeding.

My son went to sleep without the breast last night and didn't ask for it this morning.  I just explained to him that we are going to cuddle and talk now which we have been practicing over the past few weeks.  He did OK with it, hopefully it will be this easy.

[maryamb]

Kysmequick, I am so sorry for your losses.  For both pregnancies you were very far along.  Thank you for sharing your story with me.  It does say that nursing could lower your progesterone levels so I think for me it's definitely a concern.  At least my son is 2 years and 9 months now so I am ok if I have to stop breastfeeding although I wanted him to wean naturally. I know that the closeness is still very important to him because this morning we cuddled instead for 15 minutes.  I just hope that he doesn't feel like I am rejecting him.

[maryamb]

1babysmom-Thanks for telling me about the thyroid issues.  I was thinking the same thing because ever since getting pregnant, I am always freezing and I know that could be a sign.  I am going to have my midwife check it tomorrow.

[greencrunchymom]

((HUGS)) I know how scary it is to be afraid of miscarrying.  I'll keep you in my thoughts, and if you need someone to talk to, I'm here :)

[crystal_buffaloe]

This study shows no link between breastfeeding and miscarriage -- in fact, the BFing mamas had a lower risk of m/c (it wasn't statistically significantly different, though).

I lost a baby while breastfeeding my first, so we weaned and then got pregnant with this one. I had very low progesterone with the loss On an intellectual level, I knew it probably did not cause the m/c, but I was having a hard time with it, and even BFing once per day was affecting my fertility and after the loss, I really wanted to get pregnant again right away.

I would also be much more reassured by an u/s showing growth than by HCG levels, which can vary so widely.

This study calls 100+ bpm "normal" at 6.3 weeks or less and 90-99 "borderline" (under 90 is "slow"). For the "borderline" HB, the risk of m/c was about 17% -- so that's no where near as bad as the 50/50 shot your dr was saying.

[maryamb]

I am so sorry to hear about your loss and glad that you had a successful pregnancy :) My midwife did an unofficial ultrasound (my goal was to have max one ultrasound with this pregnancy, definitely not going as planned!) at my appointment last week and she said the baby's heart beat is good which was a relief!  She put me on progesterone and said between the a strong heartbeat and the extra progesterone, my risks should be the same as a normal pregnancy but obviously there's still a risk until 12 weeks.  I am just taking it day by day for now.  I did wean my son last Monday and he's taking it very well, we cuddle now.  I am glad that I was able to nurse him for as long as I did even though I didn't do it for as long as he might have wanted me to.

I am convinced the doctor at my first ultrasound had no idea what he was talking about and feel horrible for his patients that have to go through test after test in most cases for no reason.  Given that he's a "high risk" doctor speaks for itself. Unfortunately once you get a diagnosis like that from a bad doctor, other doctors don't want to speak against him or disagree with him in case something bad does happen. 

I am glad though that I am taking the progesterone supplements, it just makes me feel better even if doesn't actually do anything!