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506043 tn?1222294696

RAI and Breastfeeding--Please Help!

I have my RAI on July 11th (my WBS is on July 3rd) and I am still expressing breastmilk for my 3 month old son.  I can't seem to get a good answer about when and if I should stop pumping.  I know I can't not feed my son my milk after the WBS, and then RAI, but should I stop pumping now and let my milk dry up or pump through the RAI and dump so the iodine doesn't hang out in the breast tissue and leave me at a higher risk for breast cancer in the future.  I saw that Dr. Lupo told someone to stop breastfeeding 8 weeks prior to RAI, but on kellymom.com, it says to pump through the RAI and a few weeks after to stop the iodine from getting to the breast tissue.  My endo is no help at all on this....has anyone been told anything on this subject??  Please help!
8 Responses
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506043 tn?1222294696
I can't believe my endo never told me ANY of this!! GRRR!!!  Thanks D, I know you are in surgery right now, but I am thinking of you and praying for you!!
Helpful - 0
455126 tn?1212432198
I'm telling you, I dont know where these people get their knowledge - but they are amazing.  The last one is from the thyroidcancerhelp forum on yahoo.ca that one of the moderators on thry'vors found and posted for you.  Really  nice lady.

Anyway, sounds like you should not be breastfeeding or pumping at all :(  Sorry, I know stopping will be difficult.

I'm thinking of you...

D
Helpful - 0
455126 tn?1212432198
And:

Post by Dr. Kenneth B. Ain to the US ThyCa listserv
RE STOPPING BREASTFEEDING BEFORE RAI

This is not just a recommendation. It is a necessity. I do not
believe that any nuclear medicine facility would knowingly administer
any radioactive iodine to any woman who is intending
to continue breast feeding. This does not apply to later pregnancies,
provided that there is no need for further scanning and therapy. As a
practical guideline, womenthyroid cancer patients should tend to
avoid breastfeeding their children if there is any reasonable chance
that they would need to receive radiopharma- ceuticals at anytime
while breastfeeding.

[... and ...]

Subject: No breast feeding while I-123 or I-131 scanning. [in
response to a question about using I-123 for a scan in order to
resume nursing afterwards]

Dear ThyCa Members (in reference to the issues pasted below this
posting):

It is one of my principles of thyroid cancer management to not do
radioiodine scans on a patient unless I am prepared to give a
radioiodine treatment if the scan is positive. For that reason, it
is unreasonable to continue breast feeding while preparing for such a
scan, whether using I-123 or I-131, because only I-131 is useful for
treatment of thyroid cancer.

The time it would take to clear the radioactivity from a lactating
breast, sufficient to resume breast feeding is so long as to make
weaning or avoidance of initiating breast feeding a necessity.
In addition, I-123 scans are not considered standard care or
definitive approaches. They are proposed by some physicians and have
both attributes and negative features for evaluation
of thyroid cancer. Personally, I do not use them (although this
particular posting is not the correct venue for giving the reasons).
Please understand that the safety of both a newborn baby and the
mother's breasts is far more important than any falsely presumed
political agenda.

[... and ...]

It is WRONG ADVICE for anyone to get radioactive iodine scans or
therapies while breastfeeding. Besides the obvious risk of exposing
an infant to radioactive breast milk, the very fact that the woman's
breasts are lactating exposes them to needlessly higher radiation
doses from the radioactive iodine than in the non-lactating state,
even if the breasts are pumped and the milk discarded. Breast feeding
and lactation should be TERMINATED SEVERAL WEEKS BEFORE ANY EXPOSURE
TO RADIOACTIVE IODINE. This may involve binding the breasts or using
bromergocryptine to dry them up. The issue is NOT Thyrogen, rather it
is RADIATION EXPOSURE OF THE BREASTS!!!

Kenneth B. Ain, M.D.
Professor of Medicine
Helpful - 0
455126 tn?1212432198
Another one:

"R77. Radioactive iodine should not be given to breast-feeding women.
Depending on the clinical situation, radioiodine therapy could be
deferred until a time when lactating women have stopped breast-feeding
for at least 6–8 weeks. Dopaminergic agents might be useful in
decreasing breast exposure, although caution should be exercised given
the risk of serious side-effects associated with their routine use to
suppress postpartum lactation—Recommenda tion B"
Helpful - 0
455126 tn?1212432198
Another response:

There have been several discussion threads on RAI and breastfeeding
on Thry'vors listserv - a few copied below.

Breastfeeding should be stopped before RAI and it is very important
that your friend's doctors know she is currently breastfeeding. She
should receive specific recommendations for her situation. Most
doctors recommend stopping breast feeding for at least 6-8 weeks
PRIOR to RAI, but again, she needs specific medical advice for her
needs.
Helpful - 0
455126 tn?1212432198
Here is the first response I received:

From the reading that I have done, it's best to stop breastfeeding now
and let her milk dry up. It's best to do it gradually though. I
consulted a couple breastfeeding books and the internet and for RAI
treatment, breastfeeding should be discontinued. RAI is concentrated
and excreted in breastmilk, so I wouldn't want it hanging around in
there. And of course you can pump it off, but then you will have more
milk production. I was breastfeeding my baby when I went in for my
TT, I had to pump, just to relieve the pressure. Then I just let
myself dry up. I go for RAI July 21st. My TT was April 14th. I did my
research and for me, this was the thing to do. How old is the baby?
Mine was 12 months so it wasn't a huge deal, but it was an emotional
struggle for me to stop....I missed the quiet time together and I felt
angry that I was "forced" to stop. Just a word of warning, that
ending breastfeeding can be an emotionally difficult time....hope this
helps!!!

Helpful - 0
506043 tn?1222294696
Thank you D, I can't seem to get a straight answer anywhere, and I am sure a ton of women have been breastfeeding and then needed RAI...so there has to be an answer, right??
Helpful - 0
455126 tn?1212432198
I will also ask this question for you (if that's okay with you) on the canadian thyroid cancer support group and see what they suggest...i'll let you know (or maybe nissah can if i'm still in surgery / hospital) what they say.

Thanks for all your prayers :)

Despina
Helpful - 0
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