Lilu

Breastfeeding with Postpartum Thyroiditis

Picture of mama breastfeeding baby behind beautiful hat by artist maryam keyhani

Around 3-8% of new moms can develop postpartum thyroiditis. We recently caught up with the team at Paloma Health to learn more about Postpartum Thyroiditis, how it can affect your breastfeeding journey and some tips to manage it.

What is postpartum thyroiditis?

Postpartum thyroiditis is an inflammation of the thyroid within the first year after giving birth to a baby. 

The thyroid is the butterfly-shaped gland at the base of your neck that produces the hormones responsible for regulating the body’s energy use. When thyroid hormone production changes, it affects virtually every system in the body. 

Postpartum thyroiditis may last several weeks to several months. However, it can be hard to diagnose because its symptoms are often confused with the stress of having a newborn or postpartum mood disorders - the “baby blues,” if you will.

What causes postpartum thyroiditis?

Scientists aren’t entirely sure what causes postpartum thyroiditis. Those who may already be at risk of autoimmune thyroid disease could be more likely to develop postpartum thyroiditis. These risk factors include the presence of TPO antibodies before pregnancy, type 1 diabetes, or a personal or family history of thyroid problems. 

Symptoms of postpartum thyroiditis

Typically, postpartum thyroiditis comes in two stages:

  • hyperthyroidism (overactive thyroid), followed by
  • hypothyroidism (underactive thyroid).

The hyperthyroid phase can happen shortly after childbirth and may cause symptoms like anxiety, irritability, rapid heartbeat or palpitations, unexplained weight loss, Increased sensitivity to heat, fatigue, tremor and insomnia.

Several months after birth, in the hypothyroid phase, symptoms may include lack of energy, increased sensitivity to cold, constipation, dry skin, weight gain and depression

How is postpartum thyroiditis diagnosed?

If you experience any unusual symptoms after giving birth, talk to your health care professional and consider taking a thyroid blood test to understand how your thyroid is functioning. 

Treatment for postpartum thyroiditis

If your results show your thyroid levels are not within a healthy range, it’s easily treatable in almost everyone. Treatment depends on your symptoms, medical history, age, and severity.

The hyperthyroid phase may require treatment with beta-blockers, prednisone, or both to slow down your heart rate and ease symptoms of inflammation. During the hypothyroid period, optimizing your thyroid levels with thyroid hormone replacement medication is usually the first step in minimizing symptoms. 

You may be able to stop treatment as pregnancy-related thyroid dysfunction returns to normal in most women after childbirth.

POSTPARTUM THYROIDITIS, BREASTFEEDING, AND MILK SUPPLY

In most cases, you should be able to breastfeed with postpartum thyroiditis, whether you are currently in treatment or not. If you suspect you have postpartum thyroiditis, talk to your doctor and make sure to let them know that you’re breastfeeding so that they can support you adequately. The use of radioactive iodine, which doctors may use for testing is not safe during pregnancy or breastfeeding - so make sure to ask your doctor if they will use any radioactive materials for your evaluation, and when it is safe to resume breastfeeding and pumping after a test or scan!

Thyroid issues can cause difficulties with milk removal. So if you’re feeling like it is a bit harder than it should be, know it’s completely normal but there are things you can do that can help. 

Here is some information make breastfeeding and pumping easier for moms with Postpartum Thyroiditis: 

  1. The medication they will prescribe you should be low dosage and safe to take while nursing. Almost none of it will pass through your breast milk to your baby. If you prefer, you can take the medication after you finish a feeding. 
  2. In hyperthyroidism, you may have difficulty triggering a letdown but an over-supply of milk. While in the hypothyroidism phase you may have a lower milk supply. In either case, to help with milk removal, you can add breast massage and breast compressions to your breastfeeding and pumping sessions, to help trigger the letdown reflex. If you have a low milk supply, massage throughout the feeding session, not only the beginning.
  3. Pitocin nasal spray may help with milk flow, as it’s the synthetic version of oxytocin, which is the hormone that helps with the letdown reflex.
  4. Consult with your physician before taking any galactagogues (like fenugreek) if you have a thyroid condition.
  5. If you’re having difficulties breastfeeding or pumping, consult with a lactation consultant (IBCLC) that can guide you through establishing and maintaining your milk supply.

If you think you may be experiencing symptoms of post-partum thyroiditis, you can take 40% off your first purchase of an at-home thyroid test kit with the code WEARLILU on Paloma Health’s website

Did you, or someone you know experienced postpartum thyroidism? How did you find out and what are some things you learned along the way on how to manage it? Let us know in the comments!

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Image credit: @maryamkeyhani

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