Jaye,  TSH is Thyroid Stimulating Hormone, so when the TSH is high, it
is working hard to increase thyroid levels (which are low).  When the
TSH is low, it is trying to decrease stimulation of Thyroid because the
levels are too high.  Hope that clarifies a bit although I am not
helping with the big picture.


 
Carla Prock RN, BSN, IBCLC
Public Health Nurse
Benton Franklin Health District
800 W. Canal Dr.
Kennewick, WA 99337
509-586-0207x 237
 
[log in to unmask]
 
Public Health...Always working for a safer and healthier community
 

-----Original Message-----
From: Jaye Simpson, IBCLC [mailto:[log in to unmask]] 
Sent: Thursday, June 07, 2007 9:09 AM
To: [log in to unmask]
Subject: [LACTNET] Thyroid levels - help! Long

Hi All,

 

I am having some troubles finding out how to get some sort of 'read' on
a
clients thyroid levels.  I posted about this mom a few weeks ago.

 

This mom's milk never really 'came in'.  Short version:  Baby DOB
5-9-07.
Tongue tie evaluated and clipped Day 2.  Milk supply never really came
in.
Mom saw LC at hosp outpatient clinic who gave her a nipple shield and
suggested Domperidone (didn't run any tests on mom to rule out prolactin
issues, retained placenta, do a suck eval on baby - nothing.)  Mom
nursed
around the clock and finger fed baby supplement.  No one suggested she
start
pumping until day 6 - which she did - 8-10 times in 24 hours)

 

I came in on Day 8.  Baby has a totally messed up suck - one of the
worst
I've seen.  Tongue is still tied - needs to be re-clipped.  Baby's head
is
badly misshapen.  The right side of his head is flattened at an angle
towards the left with the left side of his head pushed way out and a
divot
in the skull just above the left ear).  That is interfering with baby's
ability to suck - so I referred out to Bowen Practitioner to assist.

 

Argued with the RN at mom's Dr about doing prolactin and TSH levels.
She
finally agreed.  Prolactin level drawn morning of Day 10 - level comes
back
at 178. (No order for draws before and after pumping - just get the one
draw
and a baseline) Mom is only pumping about 1.25 oz total per pumping.  RN
prescribed Domperidone 5-30 (80 mg/day).  After 4 days on it developed
Mastitis in right breast.  Milk supply dropped even more in that breast.
Now milk supply coming back up but only to about 1.5 oz total again.
Pump
flanges (of all sizes 24-30) don't fit well due to the shape of the
flange -
will be switching her today to Pumpin'Pals to give the graduated sizing
a
try.  

 

Parent's took baby in for 2 more evals for the tongue tie - Dr. 1 said
no
more clipping because it was only 1mm that needed to be done and that
shouldn't interfere with BF.  Dr. #2 (who I refer to often) said no
because
baby would now need to be put under because, while it was still tight,
the
way it was tight would be more difficult to do with baby awake.
(posterior
tied right at the floor of the tongue)  Parents are not willing to put
baby
under for this.  

 

Saw mom 6-6-07.  Baby looks better head-wise - but still has a ways to
go.
Suck is better but still somewhat disorganized.  Lots of pausing and jaw
tremors - tongue tie still affecting tongue movement to a degree.  Mom
has
great positioning and latch techniques.  Baby opens wide and goes on
deeply.
Baby did, however, transfer 1.6 ounces from mom without causing her
pain!
Mom was overjoyed (about ready to give up but now more encouraged!)
Bottle
feeding on Avent bottle was a joke - baby completely unable to maintain
seal, stable suction - lots of milk spillage.  We switched them out to a
long nipple (ended up with Dr. Brown's).  I had suggested this before 3
wks
ago but parents didn't comply.  

 

Mom's milk supply is still not what it needs to be.  Her milk never
really
came in - just kind of trickled in.  I would expect that even with baby
not
nursing well, the milk should come in, mom experience that fullness,
engorgement (due to milk not being removed effectively) around day 3-4.
Nothing.  It just trickled in over a period of weeks.  We finally got
her
TSH levels back.  The nurse said she was at a high normal but it doesn't
make sense to me.  The range was .34 - 4.8 and her level was .36.  The
nurse
told her that the larger number was the low Thyroid level and the low
number
was high thyroid.  Is that true?  I have had the exact opposite
description
of thyroid levels for my own levels!  

 

Any input on this would be helpful.  Mom has no other hormonal issues
(did
the Assessment for low milk supply) that would be adding to this.Had her
milk initially come in I would completely get why her supply was low,
but it
never really did.

 

Thanks for any help!

 

Warmly,

Jaye

 

 

 

 

 

 


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or
[log in to unmask])
To unsubscribe: unsubscribe lactnet or
([log in to unmask])
To reach list owners: [log in to unmask]

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]