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  • Thyroid surgery

    I have attempted to call the hotline numerous times today and have not been able to reach anyone. I hope that someone can assist me.

    I have to have a partial lobectomy of my thyroid on August 16th and cannot seem to get a clear answer from any of my doctors about whether all or part of the procedure is safe for nursing. I have an 18 month old who nurses approximately twice a day and primarily for comfort. I have been trying to wean him in preparation for the surgery, but without success. I would like to know:

    1) Is anesthesia safe for nursing? I will have general anesthesia and probably be hospitalized overnight (assuming I do not have complications). Can I resume breastfeeding when I am discharged from the hospital?

    2) The surgeon will send the right lobe to pathology and if it is cancer, they will remove the entire thyroid and then I will need a dose of radioactive iodine. The pediatrician said that I will have to fully wean 6 weeks prior to treatment but that time period has already passed (surgery is in a little over 2 weeks). Is this true that I need to have stopped breastfeeding before hand? If not 6 weeks, when should I wean? Is it possible to "pump and dump" to maintain my supply so that I can simply resume breastfeeding after the iodine dose? When can I resume nursing after receiving the radioactive iodine treatment?

    3) Is there a type of radioactive iodine that is less risky for breastfeeding? A lactation consultant suggested Technetium 99m for the lowest risk to nursing. Is this accurate?

    4) What is the worst case/best case scenario for radioactive iodine.

    Thank you for your time.

  • #2
    HMF1980:
    Sorry, but the hotline is down today due to staffing difficulties.

    In general anesthesia is safe for nursing. In your case with an 18 month old, you don't have to worry about most drugs...particularly the anesthetic drugs. I'd suggest in your case to wait about 8 hours or so before feeding. its not really necessary, but your infant doesn't really need it either.

    As to stopping breastfeeding BEFORE radioactive treatment, it is well known to reduce the exposure of the breast to radiation. I would suggest you dry up well before the procedure. BUT MOST IMPORTANTLY, YOU MUST STOP AFTER TREATMENT. Further, you'll need to stay away from your family members in a separate room for about 7 days, or at least no closer than 6 feet. The duration of separation depends on the dose, so ask your radiologist about "Close contact restrictions" If they will tell you the dose they are using, our center can advise you about close contact.

    If they completely remove the thyroid, then the close contact restriction is generally reduced, because you don't have thyroid tissue to hold the radioactive Iodine -131 and it is rapidly eliminated in the urine.

    Lastly, I-131 is the absolute best way to treat malignant thyroid tumors. Technetium, while great for hundreds of other procedures, it no good for radioablation of thyroid tissue. I-131 works like a charm, but you have to be careful around family members. It has an 8 day half-life, so it will take about 40 days to completely decay away.

    Tom Hale Ph.d.
    Professor
    InfantRisk Center





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