Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption

• Purpose To review early recommendations and propose guidelines for breastfeeding interruption after administration of radiopharmaceuticals, based on additional biokinetic and dosimetric data. Methods Activity concentrations in breast milk from 53 breastfeeding patients were determined. The milk was collected at various times after administration of 16 different radiopharmaceuticals. The fraction of the activity administered to the mother excreted in the breast milk, the absorbed doses to various organs and tissues and the effective dose to the infant were estimated.Results The fraction of the administered activity excreted per millilitre of milk varied widely from 10(-10) to 10(-3) MBq/MBq administered. For Tc-99m-labelled radiopharmaceuticals, the total fraction of the administered activity excreted in the milk varied from 0.0057 % for Tc-99m-labelled red blood cells (RBC) to 19 % for Tc-99m-pertechnetate. The effective dose to an infant per unit activity administered to the mother ranged from 6.7 x 10(-6) mSv/MBq for Tc-99m-labelled RBC to 3.6 x 10(-2) mSv/MBq for Tc-99m-pertechnetate. For the other radiopharmaceuticals, the total fraction of administered activity excreted in the milk varied from 0.018 % (Cr-51-EDTA) to 48 % (I-131-NaI). The effective dose ranged from 5.6 x 10(-5) mSv(infant)/MBq(mother) (Cr-51-EDTA) to 106 mSv(infant)/MBq(mother) (I-131-NaI).Conclusions Based on an effective dose limit of 1 mSv to the infant and a typical administered activity, we recommend cessation of breastfeeding for I-131-NaI and interruption of feeding for 12 h for I-125-iodohippurate, I-131-iodohippurate, Tc-99m-pertechnetate and Tc-99m-MAA. During this 12-h period all breast milk should be expressed at least three times and discarded. For the other radiopharmaceuticals included in this study, no interruption of breastfeeding is necessary.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

Keyword

Absorbed dose

Breastfeeding

Breast milk

Nuclear medicine

Radiopharmaceutical

Publication and Content Type

ref (subject category)

art (subject category)