PARENT CARE MATTERS
Hormone Testing for Lactation
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Summary:
Robust milk production is the product of demand and supply, however there are physiological reasons that milk production can be low. As with all body systems, the proper levels of hormones must be present for the process to work. When milk production is lower than expected in the first two weeks, a basic hormone panel blood test can be requested to look for imbalances.
Blood draw testing for hormone levels that can affect lactation including the following:
- Testosterone — if elevated, an ultrasound can confirm the presence of gestational ovarian theca lutein cysts. These benign cysts, while rare, can delay the onset of milk increase by weeks.
- TSH — If thyroid levels are too low or too high, this can negatively impact milk production. Levels are checked during pregnancy, but sometimes after delivery those levels can change dramatically.
- Prolactin — Prolactin is the hormone responsible for lactation. There should be a surge during breastfeeding. Tests should be done before breastfeeding, and again 45 minutes later to gauge the surge.
- b-hCG — If levels are high, this may indicate retained placenta, a condition where the placenta has not been completely expelled from your uterus after your baby was born. A visit with your OB/GYN is required.
- Hemoglobin — Anemia, a deficiency of red blood cells, can lead to low milk production.
- Insulin — Insulin resistance, which results in high levels of blood sugar, can be a factor in low milk production.
Steps:
- Request a blood draw with a hormone panel from your healthcare provider.
- If any levels are determined to be out of balance or out of range, request a plan of care from your medical team to address the imbalance. Sometimes this requires medication; sometimes it requires a different therapy.
- Continue to maintain your milk production by feeding your baby and/or pumping milk to empty your breasts.
Follow Up:
The most common reason for low milk supply is due to breastmilk not being removed effectively. While waiting for the assessment of your hormone levels, it is a good idea to be working with a qualified lactation professional to continue to improve your breastmilk supply.
Research
Protocol for an observational study investigating hormones triggering the onset of sustained lactation: the INSIGHT study: https://pmc.ncbi.nlm.nih.gov/articles/PMC9438014/
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