Sorry, I am nomail, but I need your help.
The sister-in-law of a friend of a friend, breastfeeding her 6 weeks old infant is in a small hospital far away, with a pulmonary thromboembolism. Doctors have convinced her to wean because of gammagraphy and heparine. I have many references for how much after a dose of radioactive Tc should bf be discontinued (even that beautiful letter from Dr. Newman, stating bf should not be discontinued at all); but in this case the doctor is adamant: "she can never breastfed, because a single atom of Tc can remain somewhere, pass to the milk, stick to the bone and cause an Ewing's sarcoma someday" I wonder if this apply also to the mother, who has received a full dose of Tc, and if every patient is informed so in deep before every gammagraphy...
But wath really surprised me was his point on heparine: he was not interested at all if it passes into the milk or not, his problem was that "mother can suffer an intramamary hemorrhage, due to suction". I had never heard of such a thing, and strongly suspects it is only a bluff; but I have been unable to locate any information. Is the dose of heparine used in the treatment of a pulmonary thromboembolism so high that a real risk of mamary hemorrhage exists? Do mamary hemorrhages exixt at all? Have you seen a case like this? Do you know of any authoritative reference? Would this mother have been allowed to breastfed, in the hospital where your work?
Please send answers privately to me, as well as to the list. To late for this mother, probably, but maybe useful ammunition for the next case...
                                Carlos Gonzalez         Barcelona
                                [log in to unmask]