A woman woman attending one of my breastfeeding classes had her thyroid
gland removed early in the pregnancy because of a malignancy, and has
been on carefully monitored Synthroid doses since.  Her questions
concerned some radioactive treatments planned for about a month after
the birth.  She didn't know the exact agent to be used, and it wasn't
clear if these were to be diagnostic scans or a tissue-destroying dosage
to clean up any remaining thyroid tissue.  I'm providing her information
(from Hale, the AAP list, the Breastfeeding Answer Book) on radioactive
treatments to share with her doctors.  (It was useful reading --  I'm
hoping it's not to be the Iodine 131 isotope, which really does
contraindicate breastfeeding, since the resources recommend weaning
*before* the treatment to minimize the breast's exposure to radiation.)
I'm also going to suggest she discuss the timing with the doctors -- if
they're willing to wait 4 weeks post-partum for the procedure, could it
wait longer?

The other question -- she is to undertake a low-iodine diet for six
weeks preceding the procedure, and the doctor recommended against
breastfeeding because he felt her milk would be deficient.  I know that
iodine is important for the developing brain, pre- and post-natally.
But since since the basic American diet has abundant iodine, it's hard
to picture that this short-term dietary change would have any effect on
milk composition, but if someone has a reference to share, I'd like to
reassure her.

I checked the archives, and an old post from Thomas Hale, offered
further reassurance that:
> The human fetal thyroid begins to concentrate iodine in the
> 12-14 th week of gestation,  and provides enough iodine for months of life
> post-partum.

But thyroid issues have cause problems with her or the baby's storage of
this trace element?  Or if her Synthroid dosage is correctly calibrated,
does that regulate everything well enough?

Can a baby's blood be checked for iodine levels?  (I'm assuming that
bloodwork would done anyway to monitor the baby's thyroid function, but
I don't know for sure.)

Margaret Wills, LLLL, IBCLC

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