Help me find literature for my doctor

[kathteach]

I have something wrong with my thyroid. Last time I went in my numbers were low and they did a thyroid biopsy. My doctor (endocrinologist) wanted to do some test with radioactive dye and I said no b/c of the breastfeeding and the doctor absolutely scoffed at me. My 2 year old was at the appointment and he asked if I had an infant at home. I said no he is my youngest. He checked my records and gave me this incredulous look and said he was born in 2007 are you telling me you are breastfeeding a three year old. I said no his birthday is in September. This was six months ago. My son turns three this week.

I have been avoiding going back because of this. I am not an assertive person, I have a fear of doctors and I don't know how to stand up for myself. I don't know if I can do this test and pump and dump. I feel like this doctor won't even tell me if I can. He is the only endo at my medical group.

I was thinking if he gave me a problem again I could give him something about the benefits of extended nursing, but all the stuff I've seen is about toddlers, like 18 month olds. Do any of you have a resource for me I could show him? It needs to be short and to the point. I am so dreading seeing him.

[annettemarie]

Moved to Breastfeeding Beyond Infancy.

[CheriK]

Are you on hormone replacement? Often, if you have low thyroid levels, the recommendation will simply be to start supplement. Low thyroid is no fun (speaking from experience) - it can impact milk supply, as well as lead to lovely symptoms that no mom needs like fatigue, insomnia, weight gain, eczema, hair loss. . .Your GP should be able to discuss starting thyroid hormone replacement (which is perfectly safe while nursing, it's simply replacing the hormone your body should be making but is not) and should be able to let you know if there is a particular reason why you need more diagnostics at this point. You may be able to delay further testing until your son weans.

If you do follow up on testing, I'd get a copy of the newest Hale's Medications and Mother's Milk (2010 edition). It's only about $35 off Amazon & has detailed listings of different radioiodine risks and length of time to not nurse after testing. There are different tests & different radioactive iosotopes, so there is usually a test w/ lower concern (you'll probably have to delay nursing for some period of time, but often hours instead of days or complete weaning). Some of the info is available on kellymom at http://www.kellymom.com/health/thyroid/index.html, but Hale's is more detailed and current.

You should also talk to the radiologist who will perform the test (who probably knows more about radioiodine and breastfeeding than your endocrinologist). The radiologist should know you are breastfeeding & should discuss the radioisotopes to be used with you BEFORE the tests are done, so you have a chance to research the recommendations.

It's not particularly your job to teach your doctor the reasons for extended nursing. If you WANT to share information, great, but don't feel like you have to. There are some studies at kellymom http://www.kellymom.com/bf/bfextended/ebf-benefits.html. You should be able to get the care you need without "convincing" him to accept your choice to continue nursing. The phrase I typically use with my doctor when weaning is mentioned is "that won't work for us." Repeat frequently as needed until you sound like a broken record. If your pediatrician is supportive of breastfeeding, you might simply say "My son's doctor recommends we continue breastfeeding." You could even say this if your ped DOESN'T, because plenty of pediatricians DO and your endo has no idea! Having something short and to the point, and practice saying it before your appointment can help (maybe practice with a friend or your partner or an LLL Leader).