Breastfeeding: Can low milk supply be due to a thyroid problem?

My wife is worried that she is not making enough milk. She was advised to get a blood test to check her thyroid. Is this a concern? What could the tests show?


Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Many mothers worry that they aren't producing enough milk for their babies. Her best bet is to get it looked at with the help of a lactation consultant. 

Two excellent indicators of an adequate milk supply are output and pattern of weight gain. Most babies regain their birth weight by two weeks, and then gain an average of four to eight ounces each week. In the first five to six weeks of life, babies typically wet six to eight diapers and have at least two to three bowel movements each day. Around the six week point they wet five to six diapers, and their stooling pattern often begins to change. Breastfed babies may stool less frequently, but they have regular, and often quite substantial bowel movements. A baby's weight gain stays fairly constant (averaging four to eight ounces per week) throughout the first three to four months of his life. Around that time it slows to three to four ounces of weight gain per week. From 6 to 12 months of age, weight gain averages 1.5 to 3 ounces per week. If your baby is healthy, happy and within these ranges, your milk supply is probably fine. If not, your baby needs to be evaluated by his doctor. Your Lactation Consultant and Pediatrician can work together to assure the best outcome for the breastfeeding relationship and your baby's health.

If you're concerned about a low milk supply, consider the following:

  1. Is your baby nursing at least 10 to 12 times in a 24-hour period? It is normal for young babies to nurse every hour and a half to two hours. That's about the amount of time it takes for breast milk to be digested. Clustering of feeds, especially in the evening hours is also very common.
  2. What is your baby's pattern of feeding? Allow your baby to come off the first breast offered on his own, without timing the feed. Offer the other breast, and when he seems relaxed and satisfied, you can switch back to the first side offered. Use these as guidelines only. Watch your baby. Allow him to control the feed. As long as he isn't (consistently) falling asleep a few minutes into nursing, your baby knows when he has had enough. Follow his lead, whether that means nursing from one breast or more.
  3. Are you and your baby comfortable while breastfeeding? While all of these are important, if positioning and attachment isn't right, there can be lots of problems! Sore nipples after the first week of nursing are a sign that some changes are needed in this area. Your baby needs to feel well-supported while nursing. Tickle his lower lip with your nipple, and when his mouth is opened wide, like a yawn, hug him to your breast, so that he takes in a good mouthful, with at least one inch of your areola. His nose and chin should be resting on your breast. Rather than pressing on your breast to make an airway -- which pulls your nipple from your baby's mouth -- cuddle your baby's bottom in closer to your body. Don't worry about his breathing-- a baby's little pug nose, doesn't need a large space to breathe easily while nursing. When your baby nurses, listen for his pattern of sucking and swallowing. As your milk ejects, you will hear your baby swallowing after every suck, with some pauses in between. If you feel your baby's sucking slows too early in the feed, some breast massage as he nurses, from the outer portion toward your nipple, can get your milk flowing and will encourage him to continue nursing.

Still, if your wife is worried about a low milk supply and has ruled out the basics, it would be a good idea to have her thyroid function checked. In a nursing mom, an underactive thyroid (hypothyroidism) can lead to a poor milk supply. Common symptoms of low thyroid function can include swelling of the thyroid, dry skin, fatigue, depression, and intolerance to cold. If blood tests show that your wife does indeed have an underactive thyroid, there are medications that can be used to correct this condition while continuing to breastfeed.

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