The duration of the F18-FDG infusion is actually quite short (a few
minutes), and counting time from the beginning or the end of the infusion
does not really change anything. After the infusion, an uptake period of
the order of 60 minutes with the mother resting is likely to be required,
and then some 20-45 minutes for the imaging itself. Whether to count time
from the time of infusion or from the time of imaging should be decided by
the medical institution administering the PET, but in any case the
difference the choice makes is not huge, as the 18-Fluorine isotope
half-life is 110 minutes.

By the way, Hale 2017 (p. 1022) says that breastfeeding interruption is not
necessary, with a note that says that AAP 2013 only recommends expressing
first feed  (see table 3 of
https://pediatrics.aappublications.org/content/132/3/e796.long#sec-9 v).

The same table 3 of AAP 2013, though, notes that the FDA-approved drug
labeling indicates to use breastmilk alternatives for 10 half-lives (i.e.,
18 h). So, as usual, drug-labeling and medical recommendation differ wildly
wrt each other, as drug maker policies and priorities put the zeroing of
any litigation risk well above breastfeeding protection.

Of course, if milk expression is used, it is not needed to discard it, as
the expressed milk is perfectly safe after sufficient radioactive decay
occurs (in the case of 18-Fluorine, which has relatively short half-life,
it can be given to the child in the following days).

Regards,

Micaela Notarangelo, IBCLC
Italy



Il giorno sab 13 mar 2021 alle ore 14:25 latterner <
[log in to unmask]> ha scritto:

> I am having trouble accessing Lactmed and looking for information on
> breastfeeding a three year old post PET scan with FDG (fluorodeoxyglucose),
> radioactive isotope being used.  Hale's info is to not breastfeed for 12 hr
> and not have close contact for 9hr.  This info from 2010.  Wondering if
> anyone have an experience with mothers who have undergone PET scan. And is
> the time limit from the start of infusion of isotope or after it is
> stopped.  Appreciate feedback; this is for my daughter.
>
> Barbara Latterner, BSN, RN, IBCLC (retired)
>
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