clotting factors and breastfeeding

[Guest guest]

Hello, .

A number of years ago, I worked with a mother with MTHFR. This condition does not seem to affect milk supply. It can cause high homocysteine levels, but these can be controlled with extra folate and other B Vitamins. The information I could find online at the time has nothing in it about affecting breastfeeding. It is also not listed in either Lawrence & Lawrence or Riordan and Wambach. I am sure that if this could affect milk supply, it would have been mentioned in Lawrence & Lawrence.

Dee Kassing

My main question was whether any of you know if "MTHFR and homocysteine factor V Leiden" can have any effect on milk supply? baby was conceived via IVF and was a twin, other baby lost at 12 wks gestation. From what I can gather, this combination of conditions affects blood clotting factors and folic acid production in the mother. I will go search on Lactnet as well.Thanks, Eden, Atlanta

[Guest guest]

>

> Saw a baby today, main complaint was nipple pain and latch problems. Baby 6

> days old. He looked a bit yellow and jaw seemed vaguely asymmetrical. I'm

> not skilled or experienced in TT assessment but appeared to have type 3

> tongue tie. Mom was/is tongue tied and had speech problems as a child, was

> relieved that TT might be the issue, and was concerned she had been 'doing

> it all wrong.' Mom has small breasts with somewhat flat nipples that are

> pink and abraded. Baby had a hard time getting latched on but was

> eventually able to stay on with mom reporting pain level of 7 on 0-10

> scale. Baby had not had a bowel movement for 30 hours, transitional, but

> had 5-6 pees and was down 8% of body weight and had passed a lot of meconium

> in the hospital. Birth had been sponaneous and vaginal. She had all the

> hallmarks of encouraging a good latch, but baby does not seem to be

> transferring milk well. Took total of 1-1.5 oz from both breasts over 45

> minutes. We had improvement of latch and comfort with nipple shield and LB

> nursing position. I talked to the ped. who will recheck bili and consider

> frenulectomy in office. Mom was encouraged to rent a pump for supplemental

> feeding (has been giving 1-2 oz via syringe/finger feeding when she was at

> her wits end with the sore nipples, per hospital LC) to protect supply.

>

> My main question was whether any of you know if " MTHFR and homocysteine

> factor V Leiden " can have any effect on milk supply? baby was conceived via

> IVF and was a twin, other baby lost at 12 wks gestation. From what I can

> gather, this combination of conditions affects blood clotting factors and

> folic acid production in the mother. I will go search on Lactnet as well.

>

> Thanks,

> Eden, Atlanta

>

[Guest guest]

If you're seeing signs that point to questionable supply I'd be asking more

questions about the IVF, if female infertility was a factor here and hormonally

related that may be a clue to the supply issues. And certainly may also be

attributed to suboptimal latch, if she has abrasions, and a tongue tie, the milk

removal is likely compromised as a result. 7/10 for breastfeeding discomfort

sounds miserable to me!

>

> Saw a baby today, main complaint was nipple pain and latch problems. Baby 6

> days old. He looked a bit yellow and jaw seemed vaguely asymmetrical. I'm

> not skilled or experienced in TT assessment but appeared to have type 3

> tongue tie. Mom was/is tongue tied and had speech problems as a child, was

> relieved that TT might be the issue, and was concerned she had been 'doing

> it all wrong.' Mom has small breasts with somewhat flat nipples that are

> pink and abraded. Baby had a hard time getting latched on but was

> eventually able to stay on with mom reporting pain level of 7 on 0-10

> scale. Baby had not had a bowel movement for 30 hours, transitional, but

> had 5-6 pees and was down 8% of body weight and had passed a lot of meconium

> in the hospital. B

[Guest guest]

,This sounds like the tongue issue is affecting milk supply.I have a blood clotting I was on Lovenox for my last pregnancy. No issue ever with milk supply.Leigh Anne O'Connor, LLL, IBCLCNYCSent from my Verizon Wireless BlackBerrySender: Date: Tue, 8 Mar 2011 23:33:17 -0500To: < >ReplyTo: Subject: clotting factors and breastfeeding Saw a baby today, main complaint was nipple pain and latch problems.  Baby 6 days old.  He looked a bit yellow and jaw seemed vaguely asymmetrical.  I'm not skilled or experienced in TT assessment but appeared to have type 3 tongue tie.  Mom was/is tongue tied and had speech problems as a child, was relieved that TT might be the issue, and was concerned she had been 'doing it all wrong.'  Mom has small breasts with somewhat flat nipples that are pink and abraded.  Baby had a hard time getting latched on but was eventually able to stay on with mom reporting pain level of 7 on 0-10 scale.  Baby had not had a bowel movement for 30 hours, transitional, but had 5-6 pees and was down 8% of body weight and had passed a lot of meconium in the hospital.  Birth had been sponaneous and vaginal.  She had all the hallmarks of encouraging a good latch, but baby does not seem to be transferring milk well. Took total of 1-1.5 oz from both breasts over 45 minutes.  We had improvement of latch and comfort with nipple shield and LB nursing position.  I talked to the ped. who will recheck bili and consider frenulectomy in office.  Mom was encouraged to rent a pump for supplemental feeding (has been giving 1-2 oz via syringe/finger feeding when she was at her wits end with the sore nipples, per hospital LC) to protect supply.My main question was whether any of you know if " MTHFR and homocysteine factor V Leiden " can have any effect on milk supply?  baby was conceived via IVF and was a twin, other baby lost at 12 wks gestation.  From what I can gather, this combination of conditions affects blood clotting factors and folic acid production in the mother.  I will go search on Lactnet as well.Thanks, Eden, Atlanta

[Guest guest]

The thing is you have a known and obvious cause of low milk supply in a baby who

is latching and feeding poorly and causing pain. The tongue-tie and structural

work should take priority.

OTOH, I would pay close attention to the other issues because of the

infertility. Does mom have PCOS? Elevated homocysteine, as seen with MTHFR is

associated with PCOS, as elevated homocysteine causes inflammation. It is my

opinion that inflammation is correlated to milk supply issues (in both

directions).

One more thing--I always look for other mid-line defects in babies with TT and

in a baby whose mom has MTHFR, it would be even more likely.

Tow, IBCLC, France

>

> ,

>

> This sounds like the tongue issue is affecting milk supply.

> I have a blood clotting I was on Lovenox for my last pregnancy. No issue ever

with milk supply.

>

> Leigh Anne O'Connor, LLL, IBCLC

> NYC

> Sent from my Verizon Wireless BlackBerry

>

> clotting factors and breastfeeding

>

> Saw a baby today, main complaint was nipple pain and latch problems. Baby 6

> days old. He looked a bit yellow and jaw seemed vaguely asymmetrical. I'm

> not skilled or experienced in TT assessment but appeared to have type 3

> tongue tie. Mom was/is tongue tied and had speech problems as a child, was

> relieved that TT might be the issue, and was concerned she had been 'doing

> it all wrong.' Mom has small breasts with somewhat flat nipples that are

> pink and abraded. Baby had a hard time getting latched on but was

> eventually able to stay on with mom reporting pain level of 7 on 0-10

> scale. Baby had not had a bowel movement for 30 hours, transitional, but

> had 5-6 pees and was down 8% of body weight and had passed a lot of meconium

> in the hospital. Birth had been sponaneous and vaginal. She had all the

> hallmarks of encouraging a good latch, but baby does not seem to be

> transferring milk well. Took total of 1-1.5 oz from both breasts over 45

> minutes. We had improvement of latch and comfort with nipple shield and LB

> nursing position. I talked to the ped. who will recheck bili and consider

> frenulectomy in office. Mom was encouraged to rent a pump for supplemental

> feeding (has been giving 1-2 oz via syringe/finger feeding when she was at

> her wits end with the sore nipples, per hospital LC) to protect supply.

>

> My main question was whether any of you know if " MTHFR and homocysteine

> factor V Leiden " can have any effect on milk supply? baby was conceived via

> IVF and was a twin, other baby lost at 12 wks gestation. From what I can

> gather, this combination of conditions affects blood clotting factors and

> folic acid production in the mother. I will go search on Lactnet as well.

>

> Thanks,

> Eden, Atlanta

>

[Guest guest]

Well, I heard back from the mom today that the ped referred them to an ENT for " level 3 tongue tie frenulectomy " and they were VERY happy with the results.  Mom is pain free now and reports nursing is going MUCH better.  I am very pleased. 

Interesting cooincidence, I was asked today about another case where, when reading through the notes, the mom had IVF and gave factor V blood clotting disorder as cause of infertility.  This mom also has low supply. 

 

The thing is you have a known and obvious cause of low milk supply in a baby who is latching and feeding poorly and causing pain. The tongue-tie and structural work should take priority.

OTOH, I would pay close attention to the other issues because of the infertility. Does mom have PCOS? Elevated homocysteine, as seen with MTHFR is associated with PCOS, as elevated homocysteine causes inflammation. It is my opinion that inflammation is correlated to milk supply issues (in both directions).

One more thing--I always look for other mid-line defects in babies with TT and in a baby whose mom has MTHFR, it would be even more likely.

Tow, IBCLC, France

>

> ,

>

> This sounds like the tongue issue is affecting milk supply.

> I have a blood clotting I was on Lovenox for my last pregnancy. No issue ever with milk supply.

>

> Leigh Anne O'Connor, LLL, IBCLC

> NYC

> Sent from my Verizon Wireless BlackBerry

>

> clotting factors and breastfeeding

>

> Saw a baby today, main complaint was nipple pain and latch problems. Baby 6

> days old. He looked a bit yellow and jaw seemed vaguely asymmetrical. I'm

> not skilled or experienced in TT assessment but appeared to have type 3

> tongue tie. Mom was/is tongue tied and had speech problems as a child, was

> relieved that TT might be the issue, and was concerned she had been 'doing

> it all wrong.' Mom has small breasts with somewhat flat nipples that are

> pink and abraded. Baby had a hard time getting latched on but was

> eventually able to stay on with mom reporting pain level of 7 on 0-10

> scale. Baby had not had a bowel movement for 30 hours, transitional, but

> had 5-6 pees and was down 8% of body weight and had passed a lot of meconium

> in the hospital. Birth had been sponaneous and vaginal. She had all the

> hallmarks of encouraging a good latch, but baby does not seem to be

> transferring milk well. Took total of 1-1.5 oz from both breasts over 45

> minutes. We had improvement of latch and comfort with nipple shield and LB

> nursing position. I talked to the ped. who will recheck bili and consider

> frenulectomy in office. Mom was encouraged to rent a pump for supplemental

> feeding (has been giving 1-2 oz via syringe/finger feeding when she was at

> her wits end with the sore nipples, per hospital LC) to protect supply.

>

> My main question was whether any of you know if " MTHFR and homocysteine

> factor V Leiden " can have any effect on milk supply? baby was conceived via

> IVF and was a twin, other baby lost at 12 wks gestation. From what I can

> gather, this combination of conditions affects blood clotting factors and

> folic acid production in the mother. I will go search on Lactnet as well.

>

> Thanks,

> Eden, Atlanta

>