Mother has hypothyroidism that was diagnosed during pregnancy and now is being treated.  Baby is doing well at the breast.  

I typically have patients with hypothyroid begin pumping ASAP(somewhere in the first 24 hours with lots of breast compression and massage) plus putting baby to the breast as often as possible.  It has been shown that in the first 6 days these women tend to have not enough milk;  also, it has been shown after that the supply is there, but getting it out is often the issue that impedes supply, hence massage, compression, pumping and possibly even nasal oxytocin.  I was told that this is incorrect management and not necessary.  

Any advice out there?  Better yet, literature to back up my management.  I am a "hands off" consultant, but when we know an issue exists I tend to be very proactive to ensure that breast milk supply has every chance to flourish.  

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