Re: I-123 breast-feeding patient

[Greg Gibbs <ggibbs@csn.net>]

Richard Wu wrote:
> 
> Dear RADSAFE
> 
> Guide 8.39 does not give the precaution recommenditions of breast-feeding
> patient who has I-123 procedure. However, the package insert of I-123
> capsule indicate that formula-feeding should be substituted for
> breast-feeding if the agent must be administered to the mother. What is the
> policy at your institution for this case. Thanks for advice.
> 
> Richard Wu, MS, DABR, DABSNM
> RSO/Medical Physicist
> United/Unity/Mercy Hospital
> St. Paul, MN

The huge issue here is the contaminants present in the I-123.  If you
have any I-129, I-125 etc the dose to the babies thyroid will be the too
big.  There are always contaminants.  We found that when you go through
the calculations of milk consumed, %uptake, and low dose to the child,
the counting time required to make sure the concentration would be low
enought was really long (in a NaI well counter).  We counted mothers
milk in many instances, and have finally decided to just not let breast
feeding mothers have I-123.  A reasonable option is a super low dose
I-131 uptake measurement and scan with Tc99m.
-- 
Greg Gibbs MS
Colorado Associates in Medical Physics
1121 Terrace Road, Colorado Springs, CO 80904
FAX 719-635-4524                  Email:ggibbs@csn.net