Photo by Jyn Meyer

Symptoms of Postpartum Thyroiditis

Symptoms of hyperthyroidism include anxiety, insomnia, weight loss, increased heart rate, fatigue, and weakness. Hypothryoidism causes fatigue, unexplained weight gain or inability to lose weight, coarse and dry skin and hair, constipation, and depression. Lots of new mothers are tired and might attribute any of the other symptoms to the demands of caring for a baby! Fortunately simple blood tests can determine whether there is indeed an underlying thyroid condition, and mothers experiencing any unusual and ongoing symptoms should contact their doctors.

How Postpartum Thyroiditis Affects Breastfeeding Women

Nursing mothers should work to protect the breastfeeding relationship with three key considerations throughout the process: (1) compatible diagnostic testing, (2) compatible treatment and medications, and (3) management of milk supply, both oversupply and low supply.

Lucky me, I have hit the statistical jackpot and had both postpartum Graves’ Disease and now postpartum thyroiditis. The first doctor I saw wanted me to pump and dump my milk for an uptake scan and encouraged me to wean altogether. Needless to say I sought a second opinion. As MyThyroid.com explains:

The diagnosis is often made clinically, and as many women are still breastfeeding at the time of presentation, it is not generally desirable or necessary to stop breastfeeding for an uptake or scan as the diagnosis can usually be made on clinical grounds alone. Obviously, breastfeeding women should not have tests with radioactive isotopes as small amounts of the isotopes can be passed along in the breast milk, which is to be avoided.

Thyroid medications (both antithyroid medications used to suppress thyroid function and thyroid supplements used to boost thyroid levels) at appropriate doses are compatible with breastfeeding. Thyroid function can affect the milk ejection reflex and hence it can cause low milk supply. My experience has been the opposite — I had significant oversupply when I had undiagnosed Graves’ Disease. This time with the low thyroid function I have not experienced low milk supply.

Your Experience

Have you dealt with postpartum thyroid issues? What was your experience? How did it affect breastfeeding, if at all?

Post from: Breastfeeding 1-2-3

A study in the American Journal of Clinical Nutrition examined weight gained during pregnancy and the elimination or retention of that weight postpartum. The authors concluded that exclusive breastfeeding for the first six months as recommended can help most women return to their pre-pregnancy weight by six months postpartum. The study also addressed one of the concerns from a previous review of similar studies in that it took into account the pre-pregnancy Body Mass Index (BMI) of the women studied. Basically it concluded that women who were heavier before pregnancy were the most likely to continue to struggle with weight postpartum. The study also concluded that exclusive breastfeeding resulted in lower postpartum weight retention in all women. Women who gained a reasonable amount of weight during pregnancy and breastfed exclusively for the first six months were likely to return to prepregnancy weight by six months postpartum. According to WebMD, researchers estimated that women who breastfeed retain 2 kilograms (4.4 pounds) less than women who don’t breastfeed at six months after giving birth.

Thanks to Mama Knows Breast for highlighting this study!

Photo of scale by peter_w.

Post from: Breastfeeding 1-2-3

Caused by postpartum hemorrhage so severe that the blood loss irreversibly damages the pituitary gland, Sheehan’s syndrome can cause breastfeeding failure. Other symptoms include loss of pubic and underarm hair, inability to tolerate cold, low blood pressure, and atrophy of vaginal tissue, as well as subsequent infertility.

p. 569. For more see:

~ Birthsource.com
~ “Infant Insufficient Milk Syndrome Associated with Maternal Postpartum Hemorrhage” (abstract) from the Journal of Human Lactation

Post from: Breastfeeding 1-2-3

If a woman follows the Lactational Amenorrhea Method (LAM) exactly, she has less than a 2% chance of becoming pregnant in the six months after giving birth. LAM has three requirements:

1. The woman’s menstrual period has not returned.
2. The baby is breastfed on demand throughout the day and night with no more than four hours between feedings during the day and six hours at night.
3. The baby is less than six months old.

Is LAM still effective if you’re pumping and bottle-feeding? No. The baby’s suckling at the breast plays a role in suppressing ovulation.

Keep in mind that not everyone feels comfortable with the Lactational Amenorrhea Method of birth control. This Pregnancy Guide article from November 2, 2006, cautions against it:

Some experts believe that if you’re exclusively breastfeeding, you’re protected from pregnancy. The theory goes like this: Breastfeeding curbs hormones that trigger ovulation. Some experts say that as long as you’ve had no periods since you gave birth, are nursing at least every four hours during the day and every six at night, and your baby is less than 6 months old, you won’t get pregnant. But BabyCenter lactation expert Susan Condon says every woman’s body responds differently to the hormonal influences of breastfeeding, so even if you’re nursing your newborn all the time, you might be wise to consider yourself fertile. LAM is risky because you’ll probably ovulate before you get your first period, so you can get pregnant without warning. And studies have shown that getting pregnant too soon after giving birth can increase your chances of pregnancy complications, such as preterm labor, and of having a low-birthweight baby.

I tend to agree that LAM is a bit risky. I believe I ovulated and had a period within eight weeks after giving birth (although my periods subsequently went away due to postpartum hyperthyroidism). LAM would not have been reliable for me.

I still think LAM has its merits, particularly when combined with other natural family planning methods. I highly recommend the book pictured above, Taking Charge of Your Fertility by Toni Weschler (click on that title link for more information about the 10th anniversary edition that just came out on November 1, 2006). Taking Charge of Your Fertility simply and clearly explains how to monitor fertility signs such as basal body temperature, cervical fluid and cervical position. By paying attention to those signs a woman can better prevent or achieve pregnancy as she desires. (Keep in mind that getting an accurate basal body temperature requires adequate amounts of sleep–something rare for most new mothers!)

What do you think? Would you or have you relied on LAM as birth control? Have you experienced difficulty with the return of your fertility while breastfeeding?

Post from: Breastfeeding 1-2-3

1. Husband/partner. If the breastfeeding mother is in a relationship, it’s important that her partner supports breastfeeding. A husband might want to give the baby a bottle–it’s such a pervasive image of how babies are fed in today’s society. A mother can reassure her husband that there will be plenty of opportunities for him to feed the baby bottles of expressed breast milk once the nursing relationship is well established. In the meantime, a mother can suggest that her husband help with burping, cuddling and diapering the baby. (If he insists on giving the baby a bottle, offer him the 3 a.m. feeding!) In my own situation, I can say that my husband quickly realized the benefits of nursing our daughter. He loved that nursing instantly satisfied her needs for thirst, hunger, comfort and pacifying.

2. Neighbor/friend. Friends and neighbors can support the nursing mother in two ways. First, they can set a good example with their own nursing relationships. Second, they can offer to bring a hot meal when the mother is recovering from birth or volunteer to babysit an older child while the mother naps with the baby.

3. Medical professionals. A mother’s obstetrician and the baby’s pediatrician can help get the nursing relationship off to a good start by encouraging the mother to breastfeed as soon as possible after the birth. They can continue to support breastfeeding by helping the mother to make medical decisions for herself and her baby that are compatible with continued nursing.

4. Doula/birth attendant/postpartum doula. Having an experienced person assist the mother during the birth can help her have a positive birth experience with minimal medical interventions, which in turn allows the mother to breastfeed shortly after the birth. A postpartum doula offers on-going support and guidance as the new family settles in at home. To learn more about doulas and how to hire one, go to Dona International.

5. Lactation consultant. A lactation consultant is specially trained to assist mothers in breastfeeding and can be particularly helpful if the new mother needs to be seen in the hospital or at home. Board certified lactation consultants (IBCLCs) have passed an independent examination and demonstrated the necessary skills, knowledge and attitude to support breastfeeding mothers. To find a board certified lactation consultant, click here. Many hospitals offer the services of a lactation consultant as part of a mother’s stay in the hospital and for a short time after she returns home. Some pediatricians also partner with lactation consultants in their medical offices.

6. Breastfeeding support group. Some hospitals and birthing centers offer support meetings and breastfeeding classes for mothers and their newborns. I took a class the day after my first daughter was born, and I found it particularly helpful to get that instruction when I had a baby in my arms for practicing the techniques.

7. La Leche League or other breastfeeding organization. La Leche League and other breastfeeding organizations around the world provide information, support and meetings for mothers, newborns and nursing toddlers. There’s a permanent link to LLL in the sidebar at the bottom right of this page.

8. Internet support. Several on-line communities exist for breastfeeding support. For information, one particularly helpful site is www.askdrsears.com (also linked on this page). Kellymom.com has message boards for information and support on a variety of topics.

9. Librarian. When we talked about recommended books on breastfeeding, I mentioned how a librarian can help mothers locate the latest versions of helpful books.

10. Pharmacist. When I thought I had thrush, my pharmacist assisted me by preparing the proper solution of gentian violet (read the link on thrush for a warning about the safety of that remedy and for information on other treatment options). Any time I have needed to take an over-the-counter or prescription medication, my pharmacist has answered questions and offered additional printed materials on the safety of the drug for breastfeeding mothers.

While the breastfeeding mother and baby form their own special pair, having the support of a whole cast of characters can enrich and extend the nursing relationship.

Post from: Breastfeeding 1-2-3