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Thread: Nothing works...

  1. #1

    Question Nothing works...

    Hi ladies

    i hope the collective wisdom here can give me a solution. Or if you think there is no hope, I'd appreciate that answer as well.

    My DS is 13 weeks now. She was born at 8lb, dropped to 7lb around day 4. I believe my mistake was not feeding her frequently enough in the first couple of days - we roomed in at the hospital, but there was no clear guidance. I wish someone had told me to wake her every two hours - start of feeding to start. We were lax about it and would only wake her every 3-4 hours. So my milk came in late and I've been playing catch up ever since.

    She got back to birth weight at 4 weeks. The pediatrician obviously pushed supplement a lot - that was the second mistake. We occasionally supplemented and I pumped after almost every feed. I never did get much during those pumps though. I later found that my thyroid (I'm hypothyroid) was HYPER for a few weeks immediately after she was born and my dosage had to be adjusted. From about 5weeks to 7weeks, she didn't gain a single ounce. We finally gave in and supplemented her about an ounce after several nursing sessions. Effectively about 6-7oz/day.

    I'm back at work now (since she was about 11 weeks) - pumping thrice a day and 30mins each time. I use a Medela Symphony with Pumpin Pals and massage while pumping. I only pump about 1.25-1.5oz from both breasts each time. She drinks about 3oz every 3 hrs. So we are still supplementing about 6.5oz a day. I pump after she goes to bed - but she has been reverse cycling lately and I'm not getting a long stretch of sleep. So I just pump enough to top off the pumped total for the day to 4.5oz. I've tried fenugreek (didn't help - is contraindicated for hypothyroidism?), Reglan (am trying to wean off of this now - no side effects, but I'm worried about long term use) and now Motherlove Special Blend (since yesterday). I switch nurse about 2-3 times each side. And cosleep and offer no supplements from about 8pm to 8am. She is gaining slowly, but steadily (about 4-5oz/week) and is a content child.

    But I really really want to try to EBF - my goal is at least a year. I've never been able to pump more than the 1.25-1.5oz since returning to work.... is it possible to increase that amount or is it too late this late in the game? What will it take? Or should I be happy that I am able to provide as much BM as I do currently?

    And what did I do wrong exactly - was it the infrequent feeding, the supplementing or the hypothyroidism? Can someone who has controlled hypothyroidism provide any insight into their breastfeeding experience?

  2. #2
    Join Date
    May 2006
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    21,259

    Default Re: Nothing works...

    Welcome to the forum!

    The first thing I have to say is that I am getting more and more irked that thyroid testing is not a routine part of postpartum care, particularly for women with preexisting thyroid problems or a family history of thyroid disease. Postpartum thyroiditis affects around 5% of women, and around 1% of will go on to become permanently hypo. If 5% of women developed diabetes following childbirth, you'd better believe that the AMA would suggest that ALL women be tested for that as part of normal postpartum care!

    When your thyroid levels are under control, they should not prevent you from making enough milk. Particularly if you're hypo and just taking replacement thryoid hormone- Synthroid, levothyroxine, whatever. You're just replacing what your body should be making, right? Being hyper can present more of a problem since the medications used to control hyperactive function can be contraindicated during breastfeeding. Anyway, my first question for you is: have you been tested recently and if so, what were your numbers?

    If your levels are normal, then the problem is probably a typical one, which is that you have the potential to produce enough milk but you're being prevented from doing so by a breastfeeding management issue. In your case, I'd guess that you're one of those moms who just doesn't respond particularly well to pumping. You'd need to pump a lot more frequently to maximize your output... Which is not necessarily possible when you're working! Another possibility would be that you are being negatively affected by use of hormonal contraception- there is at least good anecdotal evidence that even the supposedly "safe for breastfeeding" methods can decrease supply in some women. If you're using hormonal contraception, it might make sense to try another, non-hormonal form of birth control.

    I have never heard that fenugreek is contraindicated for women with thyroid problems, just for women with diabetes, because fenugreek can impact blood sugar levels.
    Last edited by @llli*mommal; May 29th, 2013 at 03:19 PM. Reason: Stoopid iPad autocorrect
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Jul 2012
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    42

    Default Re: Nothing works...

    Hi,
    Am hypothyroid had normal levels postpartumn, milk came in on day 6 , had no supply issues then , but at 6 months postpartum there was a dip in supply with poor weight gain and infrequent stooling in dd, turned out to be hypothyroid. What got the supply back was frequent nursing, switch nursing, breast compressions feed before solids and domperidone too which increased the supply overall. Supply still decreases at times of period but comes back. Feeding dd for a year and still going strong
    Last edited by @llli*lllsmum; May 29th, 2013 at 12:36 PM.

  4. #4

    Default Re: Nothing works...

    Thanks so much for your responses!

    I do think being hyper is more of an issue and then hypo. My TSH level was at 6.5 first trimester. So my dosage got upped - I stayed around 1.5 throughout the pregnancy. My milk probably came in around Day 6 also - about two weeks after birth, the TSH level was 0.1. So I was a little hyper then (considering 0.3-3 as the normal range). My dosage was readjusted to pre-pregnancy levels. I have not had them checked since - though I'm due for a six week follow up in the next couple of weeks. I'll be sure to update when I find out.

    I'm not on any hormonal contraceptive. I've always reacted weirdly to them.

    I keep seeing stuff on internet forums about fenugreek and hypothyroidism - nothing concrete. I wonder if there is some reaction because fenugreek probably helps with milk supply because it affects pituitary hormones and TSH is a pituitary hormone too. But this is pure speculation!

    So it has been a little slow at work - so I decided to add another pump yesterday. I pumped every two hours, but for a shorter time each pump (20m instead of 30) and I got about an extra ounce total for the day. What I would've gotten if I'd pumped at the end of the day after LO went to bed. I had a plugged duct on the right side (I didn't empty well Tuesday morning) - that cleared up and probably gave me a little more too. The other variables were : I had an oatmeal cookie in the morning and drank a bit more water all day. Of course - the biggest change was that I've been taking Motherlove special blend for the last two days!

    I'm going to pump more frequently whenever I can (probably twice a week). Is it really important to pump at the same time every day?

    Sorry for the questions - I just realize after scrolling through some older threads that my situation almost exactly mirrors some others (except for the thyroid issue).

  5. #5
    Join Date
    Oct 2012
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    Default Re: Nothing works...

    I don't think it's important to pump at exactly the same time every day - having a rhythm is helpful, because I always felt like my breasts "knew" when it was time to pump - but I've certainly varied by an hour or more in my pumping times depending on my schedule for the day.

    One thing I'm wondering about: you are using a very good pump, but even amongst very good pumps there are duds, and pumps are machines that can malfunction. Are you renting your Symphony? I'm wondering whether you could try exchanging it for a different one. Maybe there is some problem with the pump. Also, are you using the correct flange size? The nipple should move back and forth easily, but the flange shouldn't be so large that you don't get a good seal. Because it sounds like you are doing everything else right. I think adding in the extra sessions is a great idea. Another idea is to add in pumping while you are commuting to work, if you have a car commute.

  6. #6
    Join Date
    May 2006
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    Default Re: Nothing works...

    Quote Originally Posted by @llli*amyvos View Post
    I do think being hyper is more of an issue and then hypo. My TSH level was at 6.5 first trimester. So my dosage got upped - I stayed around 1.5 throughout the pregnancy. My milk probably came in around Day 6 also - about two weeks after birth, the TSH level was 0.1. So I was a little hyper then (considering 0.3-3 as the normal range). My dosage was readjusted to pre-pregnancy levels. I have not had them checked since - though I'm due for a six week follow up in the next couple of weeks. I'll be sure to update when I find out.
    Yes, definitely have your doc retest at 6 weeks! A normal progression for postpartum thyroiditis is to become hyper for a while, and then cycle back to hypo. Also, your new hypo "normal" may be more hypo than prior to pregnancy, so don't expect to go back to your pre-pregnancy dosage of levothyroxine (or whatever it is you take).

    So it has been a little slow at work - so I decided to add another pump yesterday. I pumped every two hours, but for a shorter time each pump (20m instead of 30) and I got about an extra ounce total for the day. What I would've gotten if I'd pumped at the end of the day after LO went to bed.

    I'm going to pump more frequently whenever I can (probably twice a week). Is it really important to pump at the same time every day?
    It's great that the 3rd pumping session yielded an additional ounce! I think that if you can keep throwing in additional sessions, you'll ultimately see more milk coming home in the bottles. Pumping at the same time is not necessary- it's generally good, but if you're choosing between 2 regularly scheduled pump sessions and 3 less regular sessions, I think 3 would get you more milk than 2.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  7. #7

    Default Re: Nothing works...

    Quote Originally Posted by @llli*bfwmomof3 View Post
    One thing I'm wondering about: you are using a very good pump, but even amongst very good pumps there are duds, and pumps are machines that can malfunction. Are you renting your Symphony? I'm wondering whether you could try exchanging it for a different one. Maybe there is some problem with the pump. Also, are you using the correct flange size? The nipple should move back and forth easily, but the flange shouldn't be so large that you don't get a good seal. Because it sounds like you are doing everything else right. I think adding in the extra sessions is a great idea. Another idea is to add in pumping while you are commuting to work, if you have a car commute.
    I AM renting the Symphony. In fact, I think it has been no better for me than the PISA I own - so I've been thinking about returning it. Is that a bad idea?

    I use the Pumpin Pal flanges and use the large for both breasts. They seem to be pain free and well-fitted - but I shall see if I can get an LC to evaluate. Another reason to move to the PISA is that I can pump in the car with the battery pack. I think I will pick up an extra set of tubing today.

    Thanks!

  8. #8

    Default Re: Nothing works...

    Quote Originally Posted by @llli*mommal View Post
    Yes, definitely have your doc retest at 6 weeks! A normal progression for postpartum thyroiditis is to become hyper for a while, and then cycle back to hypo. Also, your new hypo "normal" may be more hypo than prior to pregnancy, so don't expect to go back to your pre-pregnancy dosage of levothyroxine (or whatever it is you take).
    I'll update when I get retested! I'm at pre-pregnancy levothyroxine levels right now. I guess we'll know soon enough if I can continue on that. It is hard to like my stoopid thyroid right now!

  9. #9
    Join Date
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    Default Re: Nothing works...

    I totally get it, mama. I hate my stoopid thyroid, too!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  10. #10
    Join Date
    Oct 2012
    Posts
    2,214

    Default Re: Nothing works...

    Quote Originally Posted by @llli*amyvos View Post
    I AM renting the Symphony. In fact, I think it has been no better for me than the PISA I own - so I've been thinking about returning it. Is that a bad idea?
    Well, if it's not working any better for you than the PISA, it's just an extra expense. I guess the question is, whether there's a problem with the Symphony you're renting?

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