HELP! Doctor says I have to wean!

[iluvmybabies]

I apparently had postpartum thyroiditis with my first son because when he was about 3 they found a goiter on my thyroid. I had some blood work done and everything cam back normal. I have had my thyroid checked several times since then and it has always been normal. Except in Nov. about 4 mo. postpartum I had them checked again and this time it showed Hyperthyroidism. My ob/gyn said to make an appt. with the Endocrinologist. I made an appt but the soonest they could get me in was Feb. 28. And this was at the end of Nov. that I made the appt. Well, I started to get worried because I had lost sooooo much weight and was losing tons of hair so I made an appt. with my normal family doctor.
The first thing I said to her today was 'weaning is not an option.' But then she tells me I have to wean because the treatments and tests that they are going to do are contradicted in breastfeeding. WHAT? I have never heard that? She then gave me a list of solids to start to introduce and told me I have to have her weaned within 2-3 weeks.: This is before they even took blood again to check my thyroid levels. I was so upset and just cried the whole way home. Does anyone have any experience with hyperthyroidism? I really, really do not want to wean my dd

[touka]

I have no direct experience with this, however I did a quick search through Kellymom and found the following information regarding the testing for hyperthyroidism:

Diagnosis of an overactive thyroid can usually be based on the mother's symptoms as well as a simple blood test. On occasion, radioactive testing is used to diagnose thyroid problems. If radioactive testing is recommended, the mother can ask her physician if the test could be postponed or another, non-radioactive test, be substituted.

If the radioactive test is used, temporary weaning is recommended. "The length of time the mother needs to suspend breastfeeding will depend on the type and dosage of radioactive materials used for the test" (BAB). Radioactivity of breastmilk declines over time, and frequent milk expression will help the mother eliminate the radioactivity from her body more quickly. This milk must be discarded and not fed to the baby. (Frequent milk expression will not hasten the elimination of other drugs from breastmilk.) For pumping information see LLLI FAQs about pumping.

Here are additional links for you (if you haven't already looked at these sites):
http://www.kellymom.com/health/thyro...nks.html#hyper

http://www.lalecheleague.org/FAQ/hyperthyroidism.html - this is the info posted above, and they go into further detail about the testing/treatment. Weaning (and temp at that) is only indicated IF you would require the radioactive diagnosis/treatment.

I hope that helped a little bit.

[Lisa Lubner]

can you pump and dump while the tests are going on?? switch back to BM afterwards?

[momuveight2B]

Sounds like your babe is barely six months old? I would feel frantic too. I just want to send you and I hope you find the answers you need. Since this was the family doc I wouldn't be too quick to make any changes until seeing the specialist.

[RootSnort]

Yes, pump ahead and make a milk stash for the test (which uses radioactive iodine-123, has a half-life of 11 hours, it's best to pump and dump for 10 half-lives). You'll need to pump and dump for 5 days.

Treatment options could include a variety of things, but just for reference:
Propylthiouracil IS compatible with breastfeeding according to Briggs et al., Drugs in Pregnancy and Lactation, a very big book that is the pharmacist's most commonly use big book of answers for pregnancy and breastfeeding.

Iodine 131 for treatment (has a half-life of 9 days) would require you to pump and dump for 90 days.

[MCatLvrMom2A&X]

The only test they might do on you that would be contraindicated with bfing is the radioactive iodine test. You could have that one done then start bfing again later not sure how long later tho.


Thyroid medication are safe to take while bfing if they were not I would be in trouble since I dont have a thyroid and will take meds for the rest of my life. I would also consider finding a different endo. Mine is thrilled that I bfed and goes out of his way to tell me what a great thing I am doing for my kids.

[MOTHERoFIVE]

I live in Little Rock, AR and plan to soon start nursing school for the sole purpose of becoming a midwife! Tell me about it. Are you a nurse? How long is midwifery school? I'll be up for awhile (we'll be iced in tomorrow so I'm not going to work!) so write back if you're up.

~Erika

[paquerette]

Have you seen the big thyroid thread in Health and Healing? I've never been hyper myself but I wonder if they can start one of the safer meds and adjust a dose based on symptoms without doing the radioactive test. In addition to the temporary weaning, I think you would have to have no contact with DD during that time either.

[twinsarefun]

I'm sorry you are going through this trouble. Do you have to do the test? You could choose not to do it and just wait until you are doing with breastfeeding completely. I know that seems like a long time from now, but it may save you this trouble. In the meantime, could you just be treated for the thyroid issue without the tests or possibly take some kind of natural treatment that would help? A IBCLC told me that Thyroid Activator by Nature's Sunshine works wonders for regulating thyroid. It may be a try for you first. I hope this all works out and you don't have to prematurely wean. Are you sure the hair falling out is not just something that many of us women go through after pregnancy? The weight loss would be a concern to me. Maybe you can take the Nature's Sunshine product first and see if that helps.

[paquerette]

Thyroid Activate sounds like it might be something for hypo. I think she wants to deactivate hers.

I started avoiding soy back when I first became hypo because I heard about it causing the thyroid to slow down. I once read a post from a guy who went undiagnosed hyper for a while, and he would crave roasted soybeans and eat tons of them. He thought in hindsight that it had kept it in check for him. I don't think it's a cure-all but it might help take the edge off, in addition to anything else you might try.

[mamaSun loveMore]

Iluvmybabies:
first of all
I am in the same boat with you. Hyperthyroidism runs in my family. My mom had it during her first pregnancy and her doctors delayed treatment until my brother was born. She didn't nurse him. By the time I came along she had been treating her thyroid for years and was told the problem was corrected. She had me with midwives and nursed me for 3 years. When I was about 4 she had to start a round of treatment for hypOthyroidism. She'll be on it for life (she says. apparently thats what the doc told her.) The way she explained it to me is that the meds slow down a hyper thyroid, until eventually it stops functioning properly and then you have to medicate for hypo. scary!
Anyway, when I was recently diagnosed they presribed a different drug. When I told them I was nursing the doc changed it to the Propylthiouracil 'PTC' (that Laura (rootsnort) suggested.) The pharmacist explained to me that the newer drug was more effective and hardly anyone ever takes PTC anymore. He said its only ever really recommended in this type of situation (preggers or nursing.)
That's fine with me.

[mamaSun loveMore]

Aaaahhhh!!!!

I am at wit's end. stuggling to stay above a pit of depression today. :
I spent the whole of yesterday in the hospital, which I always find draining.
I have this mass on the left side of my face. At first I thought it was a swolen gland and I was just fighting off infection. It has swelled and swelled over the course of the last week and now its the size of a tennis ball!!!
So I went into the ER yesterday and the doc ordered a Cat Scan, but i didn't want to take in the dye (contrast) b/c of my bfing ds. When the specialist came, he berated me for not taking it, saying he couldn't determine what to do w/o it. He wanted to admit me and put me on Antibiotics through an IV. All of which are contra breastfeeding. I refused b/c I know there are often other options. Doc's usually don't take bf-ing after 6mos. that seriously and feel they can just make a mandate to wean if it suits their proposed therapy. (in my experience)
After standing my ground through a long, heated discussion, the doc finally put me on two antibiotics that aren't contraindicated and sent me home.
the problem is: I am in so much pain! I havent' slept through a night in 3 nights. Last night was the worst. But my precious ds must have nursed like 5 times last night.
I am not ready to wean him yet! And I don't think he is ready to wean! I was hoping to go until he self-weaned. But to do it so abruptly like this before he's even 1? The idea is driving me crazy! Then again, so is the pain.
What to do?
My mom suggests weaning, for this and b/c of my thyroid issues-she wants me to take the stronger meds I mentioned above. I'd rather be admitted and take in all this crap they want to put into my body if it'll make me better, and express. Then resume nursing when I am able to leave the hospital.

[iluvmybabies]

Wow mamas! Thanks for all of your info and support. I am going to start pumping today so if I HAVE to wean temporarily, I will have enough milk. I did a little research online and feel much more positive about the situation. I think the family doctor I went to see was just being radical about the treatment options. I won't go back to her again, she had no respect for my decision to not wean. I will wait until I see the endo at the end of the month, maybe my levels will be fine then!:.

mamaSunloveMore: I am so sorry you are in so much pain! I used to work for an oral surgeon and to me it sounds like maybe an infection in your mouth. Where is the swelling located? and how is your oral health? any cavities?

[DWAXSMOM]

You need to find out exactly what tests and what meds/dyes/radioactive materials they will be using . Then check with Dr Hale. I actually was extremely hyperthyroid with my first pregnancy. They told me I would have to have radioactive iodine when he was 6mos old. I would have to wean completely(checked Hale) and be away from him and other humans for a few days. The radioactive material they wanted to use stays in the ovum. I was worried about future pregnancies. I chose to stick with PTU (oral med) and see how things went. I went from hyper to euthyroid and back into hyper. When I was pregnant with my second son I was also hyper but not enough to warrant PTU. After he was born I went euthyroid and have not changed since ( 4 yrs ago). The endocrinologist says that my thyroid has burnt out. I am so glad that I did not wean or do any of the radioactive tests. Get a good endocrinologist. Make sure you are not having severe symptoms from the hyperthyroidism. PTU helped control my pulse rate and the tremors and also the weight loss. I never had severe cardiac problems or the eye problems that can be associated with hyperthyroidism. You need to educate yourself completely because most doctors do not know the role lactation has on the endocrine system.

[RootSnort]

Originally Posted by mamaSun loveMore

He wanted to admit me and put me on Antibiotics through an IV. All of which are contra breastfeeding.

There are usually alternative antibiotics, even IV ones. We often have to pick alternatives for people due to drug allergies. And many are safe for breastfeeding. After all, we commonly use IV ampicillin, cefazolin, and clindamicin in laboring Moms and those post c-section, and plenty of our Moms breastfeed. You just need a doctor who will work with you. Or perhaps he's being inflexible because he doesn't know what's safe and doesn't know who to ask. He should call the hospital pharmacy, and they should have a very large book, Drugs in Pregnancy and Lactation, by Briggs et al. These two parties need to work together to help you get the best treatment while respecting your desire to continue breastfeeding.

As for pain meds, again, Percocet and Lortab are used post c-section. We are getting away from using the morphine PCA in our breastfeeding c-section Moms, and are now using a pain pump that delivers a local anesthetic to reduce exposure for the baby. With Percocet and Lortab, just watch the baby for sedation.

As far as drugs for HYPOthyroidism, supplementation with levothyroxine is fine. You're just putting back what is missing, what the body would be making anyway. It's important to be sure the dose is set right, and to have thyroid levels checked every 6 to 12 months, but that's important whether you are nursing or not.

[snotte]

I have had postpartum thyroiditis after both my babies. I started out hyperthyroid with each one. My understanding is it does not need treatment unless you are symptomatic, that being mainly a fast heart beat. Eventually your thyroid should burn out and most women go through a hypothyroid phase, which could be permanent. Mine lasted about a year after my first pregnancy. Then I went back to normal. I was hyperthyroid for 7 months after my last baby, now I'm hypo so taking synthroid.

I would avoid the tests and simply monitor your TSH every 2-3 months.

[mamaSun loveMore]

Thank You Mamas!

I'm back! :

Turns out I had a pretty serious staph infection!!!! My lymph glands were extremely distended, and two had abcessed. :
I was admitted and stayed in the hospital for almost a week. I had to have surgery to drain the glands, and now I'm finally back home, but with a big gash in my neck for continued drainage. (of course its always covered.)
I was released on Augmentin, which I understand is fine for nursing. I pumped like mad in the hospital, despite all the docs tsking and tryng to get me to just give it up. Once they accepted my relentless determination, they actually worked with me a little. I pumped for a day after getting out, and then finally, I was able to nurse ds again.
This whole experience has affected him! He doesn't want to let me out of his sight. He nurses every 5 min. The nurses in the hospital were aghast when I told them I nursed an 11 mo. old 10 times a day. But its true! he's a snacker. He eats plenty of solids....
While I was in there, they also started me on PTU, which I know is the best for nursing, but the Pharmacist alarmed me a bit with something I hadn't come across in research- it can have a latent effect on the baby's thyroid. : Does anyone know about this?

Anyway- I really appreciate your responses. I am glad to be out of that place! I have such a hard time with hospitals now, even though I grew up around them. (My dad is a doctor.) I think its the presumption of absolute authority; the artificial/chemical health ideals that are so counterintuitive to my vegetarian/holistic mindframe; the food! Prayerfully I won't be back there any time for myself or a loved one!!

[RootSnort]

Originally Posted by mamaSun loveMore

I'm back! :
While I was in there, they also started me on PTU, which I know is the best for nursing, but the Pharmacist alarmed me a bit with something I hadn't come across in research- it can have a latent effect on the baby's thyroid. : Does anyone know about this?

I am glad you are home!

The pharmacist's gold standard reference for nursing is Drugs in Pregnancy and Lactations, Edited by Briggs. This book says PTU is compatible with nursing. It says that a little PTU does get into the milk (less than 1% of Mom's dose), but no effects on exposed babies have ever been noted. It does say that it would be a good idea to periodically monitor the baby's thyroid function.

Good luck!

[tanyalynn]

If you want to consider a different way of treating hyperthyroidism (and no, your doc will likely not approve), check out ithyroid.com. I've read it over for the info on hypothyroidism and found it extremely useful and haven't had to fill the prescription I just got for Synthroid--I started feeling better in less than 2 weeks taking my handfuls of minerals/vitamins/etc but I have no idea if that is typical for hypo, let alone hyper. But there's actually more info on the site for hyper than hypo and you may find it interesting. I am very happy with the results I'm having.