Breastfeeding as a way to feed your baby is the biological norm. It has many benefits for both you and your baby, making it the recommended way to feed your infant from the American Academy of Pediatrics (AAP) and other professional organizations. When you have thyroid disease, you can sometimes hit snags along the path that might complicate your breastfeeding.
Milk supply while breastfeeding with thyroid disease
While the act of breastfeeding isn’t any different, one of the biggest issues for people with thyroid disease and breastfeeding is milk supply. Knowing this going into your birth can be very helpful. You may even consider meeting with a lactation consultant prior to giving birth to have a plan for those first days postpartum — a crucial time for setting you up for the best milk supply possible.
To help prepare, remember to:
Feed your baby as soon as possible, including right after birth
Keep your baby skin-to-skin often
Use feeding cues — not a clock — to help determine when to feed your baby
Talk to your lactation consultant and team about your plans to build your best supply
Review points that call for assistance
Take your thyroid medication as prescribed
Breastfeeding your baby early and often from the start tells your body that you need milk, and your body will do its best to respond. Skipping feedings or going long periods of time without removing milk will hinder your ability to make milk. Since this can also be compromised by your thyroid disease, it is imperative that you breastfeed or pump often.
You will want to look for signs that your baby is getting enough milk:
Five or six wet diapers per day by day five
Three or four dirty diapers per day by day four
Your breasts feel softer after feeding
Your baby has periods of alertness
Regaining their birth weight by days 10 to 14
Your pediatrician will use a growth chart to track your baby’s weight gain. This weight will be measured against other infants as well as monitoring your own baby’s growth pattern. It is also important that your practitioner is using charts for breastfed babies, because they have a different growth pattern from formula fed babies.
There are also signs that your baby is not getting enough milk. These include:
- Sleeping a lot with few signs of alertness, sometimes called “good baby”
If you are having problems, you should immediately find the help of a lactation consultant in conjunction with your pediatrician. A lactation consultant has special training well beyond most pediatricians in the specialty of breastfeeding. This is imperative when breastfeeding is not going well or there are complications. This is your breastfeeding dream team. In addition to finding the problem and working to correct it, they can help guide you to ensuring that your baby is well cared for in the process.
An internationally board certified lactation consultant (IBCLC) is someone who is trained to help mothers and babies who are experiencing difficulties. They are trained and tested on being able to help even in complex cases. This is why it is important that you look for the IBCLC certification when building your team. If your hospital doesn’t have one or your doctor can’t recommend one, you can also look at their certifying agency for assistance.
What to consider while considering supplementing
Supplementation is providing your baby additional sources of nutrition, either donated breast milk through a milk bank or via formula. Supplementation is considered after careful evaluation. It is important to note that just because you have risk factors or signs that your baby may not be getting enough, that is simply a sign that there is a need for evaluation. While you may panic if you hear the word supplementation, don’t. This is sometimes temporary and used in order to meet the first rule of breastfeeding: Always feed the baby.
Your lactation consultant can help you ensure that you are working on your milk supply and trying to increase your production while you are supplementing. There is a delicate balance when supplementing, and you can risk lowering your milk supply, this is why you always want the guidance of a lactation consultant. There are tips and tricks you can do to help increase your supply. This can include:
Use of hand expression or pumping
Use of skin to skin and positioning to ensure a great latch
Use of supplemental nursing system (SNS) to deliver supplements and stimulate breast milk in you
Guidance for balancing the type and amount of the supplementation for your baby to protect your milk supply
Working with your practitioner to ensure that you are properly medicated for your thyroid condition
While supplementation is sometimes temporary until you and your milk supply have adjusted to the new baby, there are times when supplementation is simply what works best for you and your family. Finding the right milk supply to allow you to breastfeed as much as you can or desire to breastfeed can be done with your lactation consultant. This look differently for many families.
Some mothers choose to breastfeed during the day and supplement at night. Others supplement while at work, and breastfeed when together. There is no one right way to supplement. You might find a 50/50 split works well or maybe you’re only breastfeeding once or twice a day. It is important to remember that all breast milk is good breast milk.
Supplementing should also be done in the best way to help build or maintain a milk supply. This means that you may want to consider not just whether to supplement, but how. Will you use a supplemental nursing system (SNS) (a special device used to allow the baby to suckle at the breast and provide pumped milk or formula via a small tube.), a bottle, cup, or a special feeder? How will you stimulate the breasts to make more milk, if that is your goal?
There may also be a time when weaning is the right choice for your family. This should also be done in conjunction with your lactation consultant. Abrupt weaning can leave you in pain at risk for mastitis and other painful complications. Even if your baby goes to all feeding using donor milk or formula, you will want to slowly bring down your milk supply for your comfort and safety.
It is also important to note that some mothers are incredibly relieved when they wean, but others are incredibly sad. There is no one right way to feel. The important part is that you have been an active participant in the decisions. A caring lactation consultant is helpful at walking you through the process and making these decisions, without telling you what to do. Most mothers want to know that they did everything that they could, and unfortunately, sometimes thyroid disease or other factors complicate that.
The bottom line is that with good preparation you set yourself up for the best milk supply. By nursing and/or pumping/expressing early and often you can ensure you build your best supply. Working with a team that includes a lactation consultant will help you figure out all of your options, including the need to supplement, so you can have a feeding plan that best suits your family.