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Subject:
From:
James O'Quinn <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 4 May 2006 21:02:42 -0400
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Okay wise ones I need your help again...

Remember the vegan mom I posted about who had no breast changes  
during pregnancy,
didn't describe lactogenesis II as vigorous but had a baby who gained  
weight normally at least until day 10
but when I saw her on day 18 the baby looked skinny and only  
transfered 2/10 of an ounce milk at a nursing and may have lost 4  
ounces?

I sent her home with a scale and most nursings were under 20 grams...
I asked mom to see a doctor and get her thyroid checked and get  
Reglan...
She did both and on Reglan her supply has increased since Monday but  
it has been very erratic
The most milk she has measured at one time was 68 grams but there are  
still nursings where just 6-8 grams of milk are transferred...

Today she got a call from the doctor that her TSH levels were high  
12.36 reference range 0.4-6.0
indicating hypothyroidism and he prescribed synthroid one 25 mcg  
tablet daily...
I'm encouraged that it doesn't look like she has secondary  
hypothyroidism...

So now my question is..is there a protocol for withdrawing Reglan  
after thyroid replacement begins
or should the mom continue on the usually course of Reglan?

My other concern is that she saw a physician at an urgent care  
facility...
Should I encourage her to find a specialist or GP to for follow up?
I'm concerned about her not being under the care of someone who feels  
responsible for her on-going health...

Jen O'Quinn
IBCLC

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