Kathy Leeper wrote:
>
> I have a mom who needs and I-131 scan next week, and has not breastfed > her 15 m/o for a week.  Is using cabbage, but is concerned  about the > radioactive material collecting in her breasts.  What are the best
> herbs to add to her "drying up" regimen?

Hi, Kathy:  I'm just going nomail so I won't see other people's
responses and don't know if this is redundant.  Here goes, anyway. Why
is this mom drying up?  Why hasn't she breastfed for a week?  Am I
missing something?  Is this just a scan or is she having a radioactive
ablation of her thyroid?  If it's an ablation, I understand because she
won't be able to nurse after it's done.  But if it's a scan, why dry up?
If I had to wean for good, or even temporarily, I would want to pump and
store as much milk as possible before the procedure so that the baby
would get the stored milk until I can resume breastfeeding or at the
very least a few more days' worth of my milk after I wean.  Possibly
it's because of the child's age and her plan to wean anyway, especially
if the child is not nursing all that much anymore and doesn't need the
milk for its nutritional contents as much (but then the contamination of
her milk is probably less of a concern anyway).

It's my understanding that in the case of a scan it's okay to resume
nursing after five half-lives have elapsed, so mothers are usually
instructed to pump during that period (beginning with the scan itself,
not a week before). I also believe that the milk that's been pumped will
be safe for use after the five half-lives have gone, because the
radioactivity naturally decays anyway, so the milk doesn't need to be
discarded but can be saved for future use.

I'd also like to address her concern about the radioactivity collecting
in her breasts.  I guess if she gets quite engorged the intercellular
spaces between the alveolar cells could be disrupted and could allow
more material into the milk.  If she dries up more gradually that's less
likely.  I believe that unless she gets terribly engorged, the same
dynamics as usual apply, i.e. that substances which have entered the
milk going from a higher concentration to a lower concentration, will
then follow the gradient back out of the milk into the plasma once the
plasma levels are lower again (unless these substances are concentrated
in milk -- I'm not sure if iodine is or not; maybe Dr. Hale has more
info on that).  If they go back out, though, I wouldn't be concerned
about a buildup, and I would expect the radioactivity to also be gone
from her breasts within 5 1/2-lives.

If she still wants to dry up, she can try sage (it comes in capsules or
a tea -- I hear the tea is pretty foul tasting), parsley and
peppermint.  Hope this helps.  Regards, Alicia Dermer, MD, IBCLC.

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