Karleen writes: I'd be really interested in the rationale behind the
following....I'm guessing that it's concern about how long the radioactive
agent stays around for? 
"Mom and I also have come to the conclusion that it would be unadvisable for
her to re-lactate after the treatment."

Hale states (on page 420 of Medications and Mothers' Milk 2004) "Doses [of
I-131] used for ablation of the maternal thyroid would require an
interruption of breastfeeding for a minimum of 106 days or more.  However,
an acceptable dose to an infant, as a result of ingestion of radioiodine, is
a matter for debate."  He then goes on to say "It is sometimes recommended
that women ... pump and discard milk for several weeks after exposure to
iodine to reduce the overall exposure to breast tissues.   The estimated
dose of radioactivity to the breasts would give a theoretical probability of
induction of breast cancer of 0.32%."  And he concludes with "The Nuclear
Regulatory Commission has released a table of instructions to mothers
concerning the use of radioisotopes.  These instructions conclude that
patients should not breastfeed following the use of I 131.  In a study by
Hammami , radioactive I-131 was found to transfer into breasts weeks
following cessation of lactation.  They suggest the breast is a "radioiodine
reservoir.""

As my patient states, "The most important thing is that I am around to take
care of my baby.  I feel very guilty that my first baby received 14 months
of my breastmilk and that this baby will get much less.  I will have to get
over the idea that formula is not a healthy food for him."  This mom is
aware that both relactating as well as not weaning early enough may increase
her risk of breast cancer.  That is not a risk she is willing to take.

On that note, I still haven't gotten any definitive feedback on how quickly
involution occurs.  I suspect that it is different for each person, due to
her body's response as well as her milk supply at the time of weaning.  This
mom says that when she weaned her first child, she felt that her body
understood very quickly that it no longer needed to make milk.  She had no
soreness or leakage and never felt an MER after weaning.  But she had only
been nursing her toddler twice a day for 5-10 minutes.  With this baby, we
are encouraging not only exclusive breastfeeding, but also pumping so she
could stockpile extra milk in preparation for weaning.  So at the time of
weaning her body will be over-producing.  I think that this will impact the
rate of involution, don't you?  I'm starting to think that maybe this isn't
the best advice.  HELP!

============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
Tarzana, CA




             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html