Happy Mothers Breastfed Babies
Results 1 to 4 of 4

Thread: Relactating after newly diagnosed with Hypothyroidism

  1. #1

    Default Relactating after newly diagnosed with Hypothyroidism

    Hi there,

    I have a 6 month old baby and managed to exclusively breastfeed her for the first 8 weeks of her life. However, at 8 weeks my milk dried up. I was soooo heartbroken, and tried everything under the sun (latch analysis, fenugreek & other herbs, teas, breast massage, domperidone, pumping every 2-3 hours including at night!, etc) to get my milk back up. Nothing worked.

    Two weeks ago I tried the last thing available to me - I had a hormone test. Now I understand that if your TSH is 10 or above then you have hypothyroidism. Mine came back as 150 ! Which is crazy... I'm on meds now, but have only just started them and am on 50mgc a day. I am having another blood test in 10 days time after which time they will adjust my dose as required.

    I was on domperidone, but have just weaned off it. While ON domperidone I was producing around 10ml per breast every 3 hours. Since coming off domperidone all I get are a few droplets if I hand express.

    I am guessing that it will take a few months for my thyroid levels to level out. My questions are:

    1. I would like to attempt to relactate, but suspect that I should wait until the thyroid levels are in a better range. I did try to pump every 2-3 hours about a month ago, even through the night for around a week, but saw absolutely no change in my milk output. I don't want to go through that again if it's not going to give me results! So should I wait?? And if I wait will it not be even harder for my breasts to produce milk if I'm not breastfeeding or pumping at all for 1-3 months??

    2. My baby is exclusively formula fed now, and we are about to introduce solids. But ideally I would like to stop with the bottles, and just provide breastmilk and solids. Is there anything I can do in the meantime?

    Thank you very much for your help.

    Leanne

  2. #2
    Join Date
    May 2006
    Posts
    22,574

    Default Re: Relactating after newly diagnosed with Hypothyroidism

    Now I understand that if your TSH is 10 or above then you have hypothyroidism.
    Depends on who you ask. The normal range for TSH is usually stated as 0.5-4.5/5.0. In the future, it is possible that the range will be reduced to 0.3-3.0. The values you see from your labwork will vary somewhat, based on the lab- my understanding is that different machinery produces different numbers. Regardless, a TSH of 150 is extremely high!

    I'm on meds now, but have only just started them and am on 50mgc a day. I am having another blood test in 10 days time after which time they will adjust my dose as required.
    In my experience, it takes time to adjust to the medication and to find the proper dose. Be patient with your body and don't be afraid to go slow, particularly if you are experiencing side-effects. (In my case, side-effects were things like a racing, palpitating heart, insomnia, and craaaazy levels of anxiety.)

    I was on domperidone, but have just weaned off it. While ON domperidone I was producing around 10ml per breast every 3 hours. Since coming off domperidone all I get are a few droplets if I hand express.
    Do your doctors think it necessary that you stop taking the Domperidone?

    I am guessing that it will take a few months for my thyroid levels to level out.
    My experience was that it took closer to 12 months. Please think of this as a long-term endeavor!

    1. I would like to attempt to relactate, but suspect that I should wait until the thyroid levels are in a better range. I did try to pump every 2-3 hours about a month ago, even through the night for around a week, but saw absolutely no change in my milk output. I don't want to go through that again if it's not going to give me results! So should I wait?? And if I wait will it not be even harder for my breasts to produce milk if I'm not breastfeeding or pumping at all for 1-3 months??
    It's easier to continue lactating than to relactate. The longer you go without stimulation to or milk removal from the breast, the harder it's going to be to get back into the lactation game. So even though pumping isn't getting you great results right now, I think it provides you with your best chance of eventually getting a better supply. No guarantees, of course!!! You might end up throwing a lot of time and effort at the pump and still not get the results you want.

    What sort of pump are you using?

    2. My baby is exclusively formula fed now, and we are about to introduce solids. But ideally I would like to stop with the bottles, and just provide breastmilk and solids. Is there anything I can do in the meantime?
    The only things you can do are to continue to try to get those drops out- breastmilk is good for your baby to consume and for you to produce, even when the amounts in play are very small- and to look into donor milk, if that is something with which you are comfortable. I know it's hard to buy formula and make the bottles and see your baby chugging them down, when your plan was to breastfeed. But this situation is what formula is for and please don't beat yourself up for using it!!!

    Will your baby nurse at all?

  3. #3

    Default Re: Relactating after newly diagnosed with Hypothyroidism

    Hi @llli*mommal,

    Thanks for your reply, and apologies for not replying to you quicker! I didn't get an email to tell me you had responded, and just happened to browse to my post and see it now!

    Yes, Isobel will nurse - she loves the breast and I suckle her to sleep at around 3-4 times a day. So she is still giving my breasts some stimulation, but she's not getting any milk out since I stopped taking domperidone. Regarding whether I need to stop domperidone or not - it made me put on LOADS of weight! But then I was taking the maximum dosage at 4mg 4 times a day... I wonder if I could take something like 1 tablet 4 times a day and see if that helps me.

    So you think it will take me 12 months to get my thyroxine levels right?? That's really sad... I was really hoping to breastfeed Isobel till she was a year old. And I felt that since nothing else actually worked that it has to be that my thyroid is simply not producing the hormones needed for the demand of breastfeeding. It will be very interesting to see what the numbers are next Monday (as I'm doing another blood test). I can't help wondering if the 150 TSH levels have something to do with the pumping I was doing and the suckling that Isobel does. Do you know if there are any other hormones needed for lactation that could limit your milk production? Is it just prolactin needed?

    I know that there is no way I will be able to resume pumping every 3 hours, but what I could do is throw in 2-3 pumps a day, just to maintain? And then after I have had my bloods tested on Monday I may start on the domperidone on a small dose if you think it's a good idea. Original blood tests said that my prolactin levels were SKY HIGH. So I wanted to first see what they were after coming off the medication. They may still be sufficient for my milk production once thyroxine has a chance to kick in?? I'm not 100% sure, but that is my thinking right now. Please tell me if you think I'm wrong! Also, if they are sky high but I was still only getting around 10ml from each breast every 3 hours then I'm not sure how useful being on the medication will be? I wish I knew someone who knew the answers I'm after, but I can't find anyone...

    If there was milk in my breasts then Isobel will DEFINITELY nurse. She throws a bit of a tantrum at the moment when I'm putting her down for a nap, because she is suckling and expecting milk. And if there is nothing there it takes longer to settle her. If there was milk she'd be in 7th heaven, and would also be more than happy to be on the breast 24/7. At least I'm lucky that way - if my milk comes back I shouldn't have any trouble putting her back to the breast for her feeds.

    Regarding pumps - I've tried LOADS of them. The one I like best is a new one that isn't very well known. It's by Difrax and is so convenient because you simply put cups under your bra. You don't have to fiddle with those pesky horns. I have bought TWO difrax pumps so that I could pump both sides at the same time (they don't do a double pump). If you want to read about it just look it up on amazon. I've also used the medela single and double pump, and I rented the hospital grade medela symphony for a week when I was pumping round the clock to try and get my milk to increase. I also have the Ardo double pump, hand pump, and the medela hand pump!! I have been desperate to breastfeed Isobel! ;-)

    Thank you for your help so far!

    Leanne

  4. #4
    Join Date
    May 2006
    Posts
    22,574

    Default Re: Relactating after newly diagnosed with Hypothyroidism

    Yes, Isobel will nurse - she loves the breast and I suckle her to sleep at around 3-4 times a day. So she is still giving my breasts some stimulation, but she's not getting any milk out since I stopped taking domperidone.
    The fact that she will nurse is a huge advantage. Have you considered using an at-the-breast feeding system like a Suplemental Nursig System or Lact-Aid? That way you could feed her 100% at the breast regardless of whether or not there is milk in the breast, which would allow you to retain all the bonding and oral development aspects of breastfeeding, plus give your baby the best shot at maintaining your supply.

    I totally understand why you don't want to be on Domperidone any longer, though I think a more plausible explanation for the weight gain is the hypothyroidism; weight gain is one off he most common symptoms of a hypothyroid disorder. If you want to stick with 1 tablet per day, that certainly won't hurt your supply.

    So you think it will take me 12 months to get my thyroxine levels right?? That's really sad... I was really hoping to breastfeed Isobel till she was a year old.
    My personal experience that it took about 12 months for me to start feeling 100% normal again. It only took about 6 months to get my levels right. But that was my personal experience. Your experience could be completely different! I just think it's important to know that recovery can be slow and that you should not put too much pressure on yourself. If you get better fast, great! If you don't, please know that it's through no fault of your own.

    Regardless of how quickly your thyroid hormone levels get back to normal, you can nurse your baby until she's a year. Breastfeeding doesn't have to be all or nothing. Even if you are just "dry nursing" (baby is suckling at a dry breast), you are providing your baby with the best.

    And I felt that since nothing else actually worked that it has to be that my thyroid is simply not producing the hormones needed for the demand of breastfeeding. It will be very interesting to see what the numbers are next Monday (as I'm doing another blood test). I can't help wondering if the 150 TSH levels have something to do with the pumping I was doing and the suckling that Isobel does.
    Low thyroid function does seem to be related to milk production. The thyroid is the "master regulator" of many other systems! If you're asking if breastfeeding and pumping could cause high TSH/hypothyroidism, then the answer is no. IMO, the most likely explanation for thyroid disfunction in a new mom is something called postpartum thryoiditis, which is an inflammation of the thyroid gland following childbirth. It is often temporary but may be permanent. It may include a hyperthyroid phase (too much thyroid hormone, low TSH) and a hypothyroid phase (too little thyroid hormone, high TSH), or may proceed directly to hypothyroidism.

    Do you know if there are any other hormones needed for lactation that could limit your milk production? Is it just prolactin needed?
    It would be interesting to speak to an endocrinologist about this. I'm not an endocrinologist, but my understanding is that the primary hormones involved in milk production and excretion are Prolactin (which governs the amount of milk you make) and Oxytocin (which governs the release of milk from the breast). There are also hormones which work against Prolactin, especially Estrogen and Progesterone. Estrogen and Progesterone are high during pregnancy, and help prepare the physiologic structures of breast for lactation while also inhibiting milk production. Post-pregnancy, high Estrogen and Progesterone can cause low production, which is why nursing mothers who want to use hormonal contraction are generally offered only low-dose Progestin-only formulations.

    I know that there is no way I will be able to resume pumping every 3 hours, but what I could do is throw in 2-3 pumps a day, just to maintain?
    Every pump session you can manage will help!

    And then after I have had my bloods tested on Monday I may start on the domperidone on a small dose if you think it's a good idea.
    I personally would IF my doctor thought it was a good idea.

    Original blood tests said that my prolactin levels were SKY HIGH. So I wanted to first see what they were after coming off the medication. They may still be sufficient for my milk production once thyroxine has a chance to kick in?? I'm not 100% sure, but that is my thinking right now.
    Prolactin production is primarily governed by stimulation to and milk removal from the breast. Domperidone keeps production artificially high, compensating for what stimulation/milk removal is not doing. So if you go off Dom, Prolactin production is going to rely exclusively on the baby's suckling and whatever pumping you can do. It may be that once your thyroid levels are normalized, nursing/pumping will be sufficient to create sufficient milk, but the more nursing/pumping you can do, the better!

    Please tell me if you think I'm wrong!
    I don't think you're wrong but please remember that there are no guarantees that you are right.

    Also, if they are sky high but I was still only getting around 10ml from each breast every 3 hours then I'm not sure how useful being on the medication will be?
    I think the one thing you know is that lower Prolactin won't help you.

    I wish I knew someone who knew the answers I'm after, but I can't find anyone...
    That's unsurprising. I don't think anyone has a clear grasp of the interplay between thryoid disorders and lactation.

    If there was milk in my breasts then Isobel will DEFINITELY nurse. She throws a bit of a tantrum at the moment when I'm putting her down for a nap, because she is suckling and expecting milk. And if there is nothing there it takes longer to settle her. If there was milk she'd be in 7th heaven, and would also be more than happy to be on the breast 24/7. At least I'm lucky that way - if my milk comes back I shouldn't have any trouble putting her back to the breast for her feeds.
    This is why I think a SNS/Lact-Aid could be so helpful to you. It allows you to keep her at the breast- and even babies who go back and forth without problems often stop nursing once they aren't being nursed!- and also allows you to have all the mothering benefits of breastfeeding, like getting her down for a nap more quickly.

    Regarding pumps - I've tried LOADS of them.
    Now might be a very good time to try the hospital-grade rental again.

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •