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Antithyroid treatment of maternal hyperthyroidism during lactation
Clinical Endocrinology
|July 1, 1984
Summary
Breast-feeding is safe for infants whose mothers have hyperthyroidism, provided medication doses are controlled. Carbimazole (CZ) or propylthiouracil (PTU) use during lactation showed no adverse effects on infant thyroid function within specific dosage limits.
Area of Science:
- Endocrinology
- Neonatal Medicine
- Pharmacology
Background:
- Hyperthyroidism in pregnant women requires management with antithyroid drugs.
- Postpartum management decisions regarding lactation are crucial for maternal and infant health.
Purpose of the Study:
- To evaluate the safety of breastfeeding for infants born to mothers treated with antithyroid medications.
- To determine safe dosage limits for carbimazole (CZ) and propylthiouracil (PTU) during lactation.
Main Methods:
- Eleven mothers received carbimazole (CZ) and one received propylthiouracil (PTU) postpartum.
- Infant thyroid-stimulating hormone (TSH) and thyroxine (T4) levels were monitored during the first three weeks of lactation.
- Maternal medication dosages were kept below 15 mg CZ or 150 mg PTU daily.
Main Results:
- Neonatal TSH levels in cord blood were within normal screening limits.
- Infant serum TSH and T4 levels remained within reference ranges throughout the study period.
- One infant whose mother received PTU showed a transiently low T4 level, which normalized.
Conclusions:
- Breastfeeding is permissible for mothers treated with CZ up to 15 mg/day or PTU up to 150 mg/day.
- Monitoring neonatal TSH and T4 is recommended to ensure infant safety during lactation.
- Antithyroid drug therapy for maternal hyperthyroidism does not necessitate cessation of breastfeeding within established dosage limits.