A breastfeeding mother has a positive thyroid peroxidase (TPO) and an otherwise normal thyroid panel. Could this adversely affect her milk supply? What treatment is recommended? — Caroline Conneen, MSN, FNP-BC, Fredericksburg, Va.

TPO is one of several antibodies associated with chronic autoimmune thyroiditis (Hashimoto disease). The breast milk of a patient like the one described should not be affected by a postive TPO, and no treatment is necessary. I recommend this patient have her thyroid-stimulating hormone checked annually—or sooner if she becomes symptomatic (e.g., low milk supply), as the presence of antithyroid antibodies suggests an increased risk of developing overt hypothyroidism in the future.—Mary Newberry, CNM, MSN (165-1)

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