I spoke to the grand multip (8 preg. 7 live births in 11 yrs)who has had
lactation insufficiency for last 2 babies.  She did get her thyroid levels
read.  The T4 is low and the T 7 is low but WNL.  She does not have a doctor
("I'm never sick).  I have urged her to see a bfg friendly family doctor I
know for some advice on what these levels mean.  As you may recall, she has a
hx of post-partum chills w/ complaints of severe cold and ache in breasts,
teeth chattering etc. which started with Baby # 5 (who nursed normally and
grew well) but which has gotten more severe with last 2 babies.  There was an
ectopic preg. somewhere in there, but I don't quite have the timeline on
that.  The cold symptoms have gotten better and are not as severe.  This is
the pattern she exper. the last 2 times.  By several mo. pp  cold was no
longer a problem.  She has no other symptoms other than the presenting
problem of low milk supply which has resisted all interventions.  Her supply
is exactly where it was last time we spoke.

I told her to see a dr.to get an idea of expense of therapy (no health
insur), some idea of whether the situation will resolve totally on its own,
and how she should be monitored given this pattern. Should she see an
endocrinologist 1st, or work with fam. pract. doc? She wants to know if she
can expect her supply to improve as her levels stabilize (which she expects
them to do).  Other hypothryoid mothers I have worked with have not recovered
quickly and their supplies stayed low.  These moms have mostly been
border-line and not treated -- some until months later when symptoms
progressed.  Do any of you have exper. with hypothyroid mothers taking
replacement hormone and having a re-bound of milk production? What do you
think her chances are of having a spontaneous recovery of supply if she
stabilizes without replacement therapy?

Thanks again to those who have posted me privately  with similar cases.
Perhaps a question to ask if we are seeing grand multips with lactation
sufficiency problems is about effect of stress of preg. on thyroid function.
 Maybe its not the breasts which get tired but the endocrine system.
Thanks for group imput.
Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin, Tx