I had an interesting call from an acquaintance today.  Her baby is about 4-5
months old.  Mom has a history of thyroid cancer prior to the birth of this
baby (and his older sister).  She went in on Monday for an I-131 test to
determine if the cancer had returned.  Here is the scenario she reported to
me...

She asked her endocrinologist (who had pumped for her own premie for over a
year) about breastfeeding after the test.  The endo told her to pump and
dump for 5-7 days.  On Monday she went in for the tracer (5 millicuries of
I-131).  Before she took it she told the nuclear medicine doctor that she
was breastfeeding but that she had talked with the endo about it and was
told to not breastfeed for 5-7 days.  She said he was reading her chart and
"nodding" while she reported this.  He then said "okay, then if you don't
have any more questions..."  She took the tracer pill of I-131, went home
and did not breastfeed her baby as instructed.

On Wednesday, she went in for the test and said that the only things that
"lit up" were her breasts and saliva.  She mentioned returning to
breastfeeding to the radiologist and he said he didn't think she should do
that but to check with her nuclear medicine doctor.  She did and was told
that she was not to breastfeed, ever again for any reason.  She told him
what the endocrinologist said and he said he would talk to her.  Today he
reiterated with her NO breastfeeding.

She has pitched a fit and has contacted an attorney.  The endo is doing some
more research but genuinely believed the 5-7 days is adequate and has given
many other breastfeeding women the same guidelines.  Mom feels that if this
is an "honest mistake" on the part of the endo, that is one thing, but she
is beyond angry at the nuclear medicine doc who did not listen to her tell
him that she was breastfeeding and planned to resume.  She didn't think the
attorneys were very interested or helpful but she is documenting every can
of formula she buys, every time he spits up or cries for extended periods of
time (he has reflux), the cost of his reflux meds, etc. as well as is
gathering information on other risks to her baby from being weaned.  She
says if she knew it would have permanently ended her breastfeeding she would
have delayed the test.

I've read to her from Hale (2000) and the 1994 AAP guidelines.  Her endo is
still working on it as well and we are all hopeful that because it was such
a very low, diagnostic dose that she will be able to resume breastfeeding
soon.

From what I have read in Lawrence (AAP) a test dose of I-131 requires 36
hour cessation and a diagnostic dose is 2 weeks.  She says she had a test
does.  My understanding from Hale is 8 days with her low tracer dose.

Does anyone have any experience with a mother having such a low does (5
millicuries) and returning to breastfeeding?  The archives do not address
tracer doses.

Kathy

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Kathy Koch, BSEd, IBCLC
Great Mills, MD
mailto:[log in to unmask]
"Children in a family are like flowers in a bouquet: there's always one
determined to face in an opposite direction from the way the arranger
desires."- Marcelene Cox

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