Those of you who read my former blog had to cringe through several posts lamenting my breastfeeding struggles, in particular the fact that it seemed I wasn't able to make enough for little Fi.
This past weekend, I finally learned why.
Okay, background: I have Graves' Disease, an autoimmune metabolic disorder. To treat it, I had radiation therapy to destroy my thyroid gland, so I no longer make my own thyroid hormone. To keep my metabolism at the right level I have to take synthetic thyroid hormone every day, just as a diabetic has to take insulin. When I was pregnant, my physicians had to increase the amount I was taking because my body's metabolic needs increased dramatically.
The week after Fi was born, I had myself tested and it seemed everything was fine. But within days of that test I started feeling really anxious and shaky. I would wake up at night -- when I could sleep, that is -- drenched in sweat. All of my pregnancy weight was gone within 12 days of the birth. I should have recognized the symptoms as hyperthyroidism because I've experienced them before, but all of my books said that sweating, weight loss, and anxiety are normal for the postpartum period.
So, I lived with it and had my thyroid tested 6 weeks later, as recommended. The test confirmed that I was hyperthyroid, and pretty severely so. My endocrinologist dropped my thyroxine dose a level and told me to get tested again 6 weeks later. Fast forward: the repeat test revealed that I was still hyperthyroid, even MORE so than before (!), so my doc dropped me all the way back down to my prepregnancy level. Within a few weeks the sweating had subsided and I could actually sleep again. I was "normal" once more. Throughout the whole thing, I was pumping like a madwoman and berating myself for not being able to provide enough milk for Fi. I felt crushed when, at the age of 11 weeks, she said TO HELL WITH IT and went on a permanent nursing strike, opting for the bottle instead.
Only now, 6 months after Fi was born, have I learned that excessive thyroid hormone impedes the release of oxytocin, which is essential for milk letdown. I was making enough milk, it's just that Fi couldn't get it OUT. I'd do these before-after weighings at the breastfeeding clinic and want to cry upon learning that, after 40 minutes of feeding, she got a grand total of 1.5 ounces. I read all the books that said THERE'S NO REASON YOU CAN'T MAKE ENOUGH MILK and actually believed them. I was so, SO hard on myself and felt like a loser for supplementing with formula.
The irony is that the only mention those books make of thyroid issues and breastfeeding is that being hypothyroid can prevent you from making enough milk. Not one mentions that being HYPERthyroid can prevent the milk you make from effectively transferring into your child's body. So I was obsessed with avoiding hypothyroidism and begged my endocrinologist to lower my supplemental thyroid dose only one notch at a time. When he lowered me multiple dosage levels after the second 6-week test, I was terrified that I would lose the capacity to make any milk at all. Instead, my supply went up enough that I was able to pump more than twice as much as before. By that time, though, Fi was firmly attached to the bottle, and who could blame her? Mom's taps were sources of frustration, not comfort.
Here I am, 6 months out and still pumping, and I can't express how much of a relief it was to learn the real reason for my difficulties. It's not just because I found out that IT WASN'T MY FAULT (which is always a relief regardless of the trauma, let's be honest), but because now I feel empowered to deal with it in the future if I have another child. I can ask my endo to lower my supplemental thyroxine dose soon after delivery rather than making me wait 6 weeks, then another 6 weeks, et cetera. And if I have another episode of hyperthyroidism in spite of my endo's and my best efforts, I'll supplement with formula without a second thought because, after all, my job is to FEED MY CHILD. Now that I look back on those months, I'm so glad I made that choice, in spite of all the warnings that formula would be the beginning of the end of my nursing relationship with my daughter. What did those people know of MY body and its needs? And when they claimed that knowledge, why on earth did I believe them??
Oh well, that's water under the bridge now. At her 6 month well-baby appointment, Fi was 16 lbs 10 oz and 28" long. That's up from 8-15 and 22" at birth.
I fed my child. *beams*