Thank you to Pat, Ann and Cheryl for responding so quickly to my patient's
needs.  

An update on her condition - she finally feels like her breasts are full and
her baby this afternoon appeared "milk drunk".  

From all of your advice, as well as Hale's recommendations, I plan to
recommend the following:

1. She should definitely start out by breastfeeding.  I will help her to
attain a deeper latch to avoid her sore nipple problem.
2. I will recommend she include pumping in her routine so that she can begin
to stockpile her milk in preparation for the iodine treatment.
3. I will recommend that she speak to her physician about putting off the
procedure for as long as is medically safe and about the possibility of
using an agent other than
 I-131 that may be less hazardous.
4. I will recommend that she weans approximately 3-4 weeks before she has to
have the iodine treatment.  She needs adequate time for her breasts to
involute.  I will suggest that she speak with her OB about using medication
to help her involute faster.
5. She and I have already discussed that it may be necessary for her to not
have close contact with her baby for a period of time after the iodine
treatment.
6. Mom and I also have come to the conclusion that it would be unadvisable
for her to re-lactate after the treatment.

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




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