Pam Holland posted about a mother who had had a c/sec & hysterectomy
followed by a pp hemorrhage, now having probs w/milk supply.
Re: loss of underarm hair - suspect this is due to extra-low estrogen levels
due to her surgery. Even if ovaries are intact, it would be very normal for
the interference in blood flow (caused by the surgery) to lead to
suppression of nl. ovarian function - hence estrogen even lower than common
w/nl. bfing woman. Hard to tell what to expect post-bfing, but should be a
temporary situation IF ovaries are intact. She may notice other
menopause-like sx. as well - night sweats, hot flashes, changes in hair,
skin, etc.
Re: TSH (thyroid) - she could well have a thyroiditis (inflammation of
thyroid) even with "nl" TSH levels. Esp. in the presence of other
menopause-like sx. (see above for reasons why this wouldn't be unusual at
this time), TSH values alone aren't necessarily sufficient. A thyroid
antibody screen might give a more accurate picture, if they are really
looking into the thyroid situation. She may need to be quite specific in
asking her doctor to do it, as it's not routinely done when evaluating
thyroid. In thyroiditis, (Hashimoto's is one type, but there are many), the
inflammation of the thyroid gland leads to the production of antibodies,
which act as "blocking agents" to keep the thyroid hormones from functioning
properly. So TSH can be normal for a long period of time, T3 &t4 will be
normal - i.e. body's producing it, but it's not being taken up &utilized
properly.
One more note - everything she's gone through PLUS low estrogen, low iron,
and maybe non-functional thyroid use, PLUS problems with milk supply, etc.
may ALL contribute to her feeling depressed, foggy, not coping as she would
maybe like to be. Please reassure her that once these hormonal things get
under better regulation, she will feel better - she's not losing her mind!
And saying "it's just stress" isn't a good enough answer! She's going
through a real storm of hormonal shifts right now, and she CAN be treated &
helped!
Sorry this may not be much help specifically re: lactation concerns, but
things to be aware of as you proceed with her & help her get straightened
out.
Cathy Bargar, RN, IBCLC Ithaca NY
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