How is baby's growth? If the baby is growing well on breastfeeding when 
mom is home, but mom can only get a little milk with the pump, it could 
be a pump/breast fit issue. Does she get more if she manually expresses? 
Does she have very elastic nipples? Pumps seem to work poorly for 
mothers with elastic nipples, because the nipples get drawn so far into 
the nipple tunnels that the nipple pores get pinched off and milk does 
not flow well.

If baby is not growing well, then perhaps mother's prolactin levels have 
dropped too low to maintain lactation. The interactions between the 
various hormones are somewhat complicated. Some mothers turn T4 into T3 
more slowly than others, and even with T4 supplements are low on T3. If 
this is the case, they often feel exhausted and have difficulty 
thinking. Thyroid hormones are important for breast tissue 
differentiation (creating milk glands) and if a mother has low thyroid 
hormones during puberty or pregnancy, they can have difficulty 
maintaining milk production.

Finally, what were the indications of oversupply? Was milk spraying from 
6-7 nipple pores at once? Was the baby gaining much more than the 
optimal amount of weight?

For now, figuring out a way to remove milk effectively might help, 
prolactin stimulating medications might help. Hopefully mom has access 
to a good breastfeeding medicine physician or endocrinologist to try to 
tease this out.

Catherine Watson Genna BS, IBCLC  NYC  www.cwgenna.com

On 8/5/2019 8:29 PM, Molly McMillion wrote:
> (PTP) I have a mom of a 4 month old who really wanted to nurse this baby
> (2nd baby) especially after first had  “reflux” and terrible “allergy”
> issues with formula. She was doing well, even had a little oversupply at 2
> months so I had her cut out pumping and just nurse. Kicking myself now
> because she returned to work a month ago and has struggled to pump  even
> 1-1/2 oz total for the day while away from baby. She has hypothyroid and
> we’ve chased her levels (up and down) for months. She is now in the normal
> range, but milk supply is further dwindling. She is currently pumping on
> average 9-11 times in 24 hours and  begging to take supplements especially
> Fenugreek but I see that it is a “no” with thyroid issues? She’s tried
> fennel, blessed thistle raspberry leaf and dill with no increase.
> Suggestions? Thoughts on thyroid issue?

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