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Good day! Can breastfeeding mother go on colposcopy, where is using Schiller's test? How many times it can be safe?
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placebolrv,
Mom needs to wait 72 hours after each Schillings test to nurse because of the radiolabeled isotope. The most common isotope used with the Schillings test is Cobalt 57 and Cobalt 58. The are not any close contact precautions with these isotopes. The fewer times she has to have the test the better, but Dr Hale said there is not a limit on how many times she has to have it as long as she waits 72 hours after each test.
There should not be a problem with the colposcopy unless they give mom something to relax her for anxiety, or for pain. If they do give her something for either of those we would need the name and dose to advise properly on the medications.
Sandra Lovato R.N.
InfantRisk Center
806-352-2519
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placebolrv,
With the Schiller's test she needs to pump and dump for 24 hours after each test because of the potassium iodide and iodine. Dr Hale is not sure how many times it can be repeated safely, but if she pumps and dumps after each application it would probably be ok if not done too frequently. There have been two cases of iodine toxicity reported.
"Two case reports have been published regarding infant hypothyroidism after exposure to iodine in breastmilk.[4,5] In the first case report, the mother was applying iodine soaked gauze to her c-section scar after the birth of her 31 week preterm infant.[4] On day 4 of life the infants thyroid function was found to be normal; however, upon repeat 2 weeks later the infant had an elevated TSH and borderline T4. The results were thus repeated again one week later and the TSH was even higher and the T4 and fT4 were low. Upon learning of the maternal history the infants urine was tested for iodine, it was above normal at 684 µg/L (normal 42-350 µg/L) and the maternal milk concentration was tested, 1911 µg/L (normal 5-185 µg/L). The infant was treated with L-thyroxine and the mother pumped and dumped her milk for 1 week after stopping iodine therapy. The infant was eventually discharged from NICU on L-thyroxine, and had no long term complications." (Medications and Mothers' Milk database, Dr Thomas Hale PhD).
In the second case report a 15 day old infant was found to have a high TSH, low fT4 and high urine iodine concentration 410 µg/L.[5] The mother reported using iodine antiseptic for her episiotomy and her milk concentration was 300 µg/L. This infant was also treated with L-thyroxine, and the authors reported no long-term complications." (Medications and Mothers' Milk database, Dr Thomas Hale PhD).
4.##Smith VC, Svoren BM, Wolfsdorf JI. Hypothyroidism in a breast-fed preterm infant resulting from maternal topical iodine exposure. J Pediatr 2006;149:566-7.
5.##Kurtoglu S, Akin L, Akin MA, Coban D. Iodine overload and severe hypothyroidism in two neonates. J Clin Res Ped Endo 2009;1(6):275-77.
Sorry about mix up on Schillings test
Sandra Lovato R.N.
InfantRisk Center
806-352-2519
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