Breastfeeding and Thyroid Problems: FAQ

This approach has been deeply established in the clinical practice of physicians for decades. However, in vitro models are often differentiated from in vivo circumstances 4. In the case of drug transfer from maternal plasma to milk, the physiochemical properties and concentrations of a pharmaceutical agent are not always translated into clinically significant consequences affecting the newborn. Several additional parameters are of major importance in the occurrence of epiphenomena that could predispose breastfeeding children to drug toxicity related to maternal drug exposure 16.

Breastfeeding and Thyroid Problems: FAQ

The amount of time suggested for suspending breastfeeding varies depending on the dosage and form of the isotope (there are many forms of Tc-99m). For some tests, breastfeeding can be resumed immediately; for others it is recommended to suspend breastfeeding for amounts of time varying from 6 hours to 48 hours. The good news is that the vast majority of women with thyroid dysfunction give birth to healthy infants – and all newborns in the U.S.A. are automatically screened for thyroid dysfunction, so that any potential issues can be identified quickly. Moms who are hyperthyroid have elevated thyroid hormone (usually T4) levels. Symptoms include weight loss (despite an increased appetite), nervousness, heart palpitations, insomnia, and a rapid pulse at rest.

What is the thyroid and what are the main thyroid disease?

• The new guidelines recommend TSH testing for all women seeking treatment for infertility, with levothyroxine recommended for cases of overt hypothyroidism.
• The guidelines note that women who are pregnant or breastfeeding should ingest 250 micrograms of iodine daily.
• These characteristics favor the increased passage of MMI over PTU into the human milk.
• I-123 has a half-life of 13.2 hours, and is available in several forms.
• The most common forms of thyroidism are hyperthyroidism, hypothyroidism, and postpartum thyroid dysfunction.

Approximately only 0.025% of the administered PTU dose was transferred, suggesting that PTU is minimally concentrated in breastmilk 10. These amounts were considered nonsignificant for inducing adverse effects for the suckling infant. It was demonstrated that the amount of MMI excreted in milk was equal to MMI levels in serum, with a total of 70.0 μg MMI excreted in the milk of normal lactating subjects, 8 h following oral administration of 40 mg of MMI. The authors hypothesized that these levels of MMI could have a potentially harmful effect on the infant 12,13. Block-replace therapy, which involves giving large doses of ATDs in conjunction with replacement hormone, is not recommended during pregnancy, due to the risk of fetal hypothyroidism.

Thyroid in pregnancy – FAQS

MMI should be used instead, at the minimal effective doses of up to 30 mg/day, while PTU should be used only in women with previous allergic manifestations to MMI for a restricted time period. Permanent treatment of thyrotoxicosis, such as ablation with radioactive iodine or thyroidectomy, should be considered in such cases when an euthyroid stage will need to be secured. Continuation of breastfeeding under ATD should be encouraged by clinicians as long as the proven benefits of breastfeeding and the risks are discussed extensively with the new mother in order to provide an integrated therapeutic approach.

Some moms with hyperthyroidism are also prescribed beta-blockers (such as Propranolol/Inderal) or calcium channel blockers to relieve the neurological and cardiovascular symptoms of hyperthyroidism. Many of these drugs (including Propranolol/Inderal) are considered to be acceptable for use in breastfeeding mothers. Levothyroxine is secreted in extremely low levels into breastmilk, if at all. The estimated level to which the baby will be exposed is theoretically 0.6 nanogrammes per kilogramme per day – virtually undetectable.

• This approach has been deeply established in the clinical practice of physicians for decades.
• Previous experimental studies assessed the excretion of ATD into human milk 10,11.
• It is worth repeating blood levels after delivery as anecdotally, fluctuations seem common at this time.
• The thyroid autoantibodies are IgG immunoglobulins, which are too large to pass into breastmilk.
• Thyroid surgery is only recommended during the second trimester and for specific situations, particularly women who are unable to take antithyroid medications.
• Symptoms are initially controlled by anti-thyroid drugs (carbimazole or propylthiouracil) and beta blockers.

It provides multiple advantages for the mental and physical development of the infant and is also implicated in the reduction of the development of several diseases in adulthood 3. Breastfeeding period comprises a critical time frame during which a newly diagnosed disease or the relapse of a chronic autoimmune disease in a new mother could encumber her physical status, hindering the breastfeeding process in several aspects. Both hyperthyroidism and hyperthyroidism can affect lactation, so proper control of thyroid levels is critical for women who are breastfeeding. Any testing or therapeutic treatments with radioactive iodine are generally not recommended while breastfeeding. However, if necessary, I123 can be used if the mother waits several days for the radioactive iodine to clear her system before resuming breastfeeding.

Is it safe for a mom to breastfeed with hypothyroidism?

It is also recommended that iodine levels be monitored and treated, if they are not at appropriate levels. Let your obstetrician and personal care physician know if there is a family history of thyroidism. That’s why taking levothyroxine to balance the thyroid levels in your body is important. When your thyroid levels are normal, you’ll likely produce enough breastmilk for your baby. It’s okay to have concerts, but it’s important to remember that taking levothyroxine while breastfeeding is fine. And when you take levothyroxine, only extremely low levels of the drug will pass into your milk.

Is it safe for a mom with thyroid disease to breastfeed?

When the thyroid is not functioning correctly, it can impact milk production. There is also connection between thyroid disorders and autoimmune problems. You don’t want your body reacting to your growing baby as a foreign invader! Problems with the thyroid can begin before or during pregnancy, in the postpartum period, or later in life. They can also occur along with other medical conditions, which can make diagnosis and treatment more challenging. Thyroid hormones are important for your milk supply, so having a thyroid disease may interfere with its production.

The standard treatment options for Graves’ synthroid gingivitis disease come with special considerations during pregnancy. Thyroid surgery is only recommended during the second trimester and for specific situations, particularly women who are unable to take antithyroid medications. Moms who are hypothyroid have low thyroid hormone levels and elevated TSH (thyroid stimulating hormone) levels. Symptoms include cold intolerance, weight gain, dry skin, thinning hair, poor appetite, fatigue, depression and reduced milk supply. Thyroid issues often cause difficulty with milk supply and with milk removal. Mothers may find their thyroid levels change with pregnancy and childbirth, which is why frequent testing of mother is recommended.

But don’t worry; it’s safe for a mom with hypothyroidism to breastfeed her baby. This scan can be done using radioactive iodine (I-131 or I-123) or technetium-99m pertechnetate. This test requires temporary weaning for a minimum of 12 hours, depending upon the isotope used (see below). Many times, this test can be skipped and a fine needle aspiration biopsy done instead (which does not require an interruption of breastfeeding).