Hello wise ones. I have permission from the mom to post for some further
insight.
Mom was diagnosed with hypothyroid at age 11. Treatment with Synthroid.
Next, when she was older mom was diagnosed with hyperprolactemia and treated with
Parlodel for two years and then conceived. Has been off parlodel since
before conception and not used at all during pregnancy. Had gestational diabetes
(borderline) during pregnancy, induction at 39 weeks. Had healthy full term
complication free birth. Baby breast feeding well, but seemed to be always
hungry, lost too much weight, went to supplementing and then baby would not take
the breast. Mom reports not ever feeling like her milk 'came in' but reports a
cup size change during pregnancy. Mom was pumping and only getting one ounce
or less each time (pumping 8+ times per day. I saw mother on day 22. Over
the phone we had discussed ways to get the baby to latch, and mom was
successful, but baby would not stay and was easily frustrated. Her original goal was
'the milk' but after the first few nursings, her goal became the breastfeeding
itself and using the bottles was very upsetting to her. She decided to use
the SNS so that her baby could be at breast for supplements, and since he would
get milk he would stay latched. Perfect. Now he is nursing and gazing up at
momma and very happy. Mom goes to endocrinologist with the hope that her
thyroid levels have changed due to the birth (the dosage were changed during
pregnancy) and hopefully that would give her an explanation and solution. Her
prolactin levels were also checked. Below are the levels back from the lab and
according to the endocrinologist, they are within normal ranges and should not
be a barrier to milk production. She was quite upset, and as she said, never
so sad to be told she was 'normal'. All the usual protocols to increase milk
production are being followed, including pumping after feedings. He is
definitely latched well, and every few feedings mom will nurse him without the SNS and
he will be happy and fall asleep content, but it is not often. When she pumps
after feedings sometimes she gets absolutely nothing, sometimes a few cc's --
sometimes as much as half an ounce. She has already tried fenugreek with
absolutely no change at all. She is willing to try the domperidone next. Can
those of you who understand the levels necessary in general for adequate milk
production let her know if these are within normal for a lactating mother? Also,
those with helpful hints to add or more information I am missing please pass
that on to. I would like to be able to share this information with her, so
with your post to list, can you post privately also with permission to share?
Lab levels:
prolactin 61.9
thyroid TSH 1.052
T4 11.5
T3 uptake 28
3.2 free thyroxin index
She sat in her endocrinologists office in tears, and for the first time he
was kind to her and told her what he sees tells him there should be no problem,
but she thinks he would be willing to adjust as necessary to help her as long
as he had some reliable information to support it.
Thank you very much.
Pam MazzellaDiBosco, IBCLC
FL, USA
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