Rebecca, I have had several similar cases recently. In two cases the doctors
honored my suggestions for lab work and we found the answers. One was low
thyroid and the other was low prolactin. In one, the mom was given thyroid
hormone and her supply rebounded within about a week. The other was given
reglan, to which she had a bad reaction, so she is on domperidone, not at my
recommendation, but because she did her own research and negotiated with her
doctor. (This whole healthcare partnership thing CAN work!!)
I read about postpartum thyroiditis and discovered that it is more common than
one would imagine. This is a very important cause to keep in mind. I have to
read more on the low prolactin idea. One possible cause: I know there is
something called "pituitary shock", which can happen if mom bleeds heavily
during the birth. This one is recoverable. (I understand that Sheehan's Syndrome
is permanent. Is that correct?) I had a very interesting case that helped me
understand pituitary shock. First baby, heavy bleeding, no milk, weaned to
fromula very soon after birth. Second baby, did not attempt. Third baby, did not
nurse, experienced postpartum engorgement. Fourth baby, when I met her, her milk
came in and she came to me for latch help. She said, "if the milk is going to
come in, I hate to waste it!". Very practical. Very instructional to me.
NOTE---disclaimer---I did not have lab support for my explanation.
I have one more anecdote that may be helpful in the general discussion. Mom gave
birth to a 36 week premie who nursed well (per mom). Mom was never advised to
pump. Baby nursed VERY frequently for months. Adequate supply overall, but slow
"delivery".
Another story: I know a mom with a very NONdemanding baby whose slowed growth
was the first sign of supply issues. Careful attention and herbal/medicinal
supplements helped the supply rebound. This was the first baby I ever saw that
was "happy to starve". Since then I have met two more. OMG!
I hope this is helpful. Rowena
Rowena Tucker IBCLC
Texas, USA
I can't wait to see Winnie's "Lactnetter" stickers at the ILCA conference in San
Antonio this week!
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