Hida Scan and Breastfeeding

[summermess]

Im supposed to get a HIDA scan and the lab is telling me that I cannot breastfeed my 5 month old infant for 72 hours. They are also telling that I can not hold my baby for 24 hours and that I need to pump and dump.

I will receive Technetium 99m (he said also called it Choletec) and he stated the amount to be 6 mci.
My questions are:

1. Do i need to interrupt breastfeeding and for how long?
2. If I cannot breastfeed after the test, do I need to dump all my pumped milk
3. If I do not have to dump, how long do I have to wait to use it?
4. Can I hold my child after test, and if not then how long do I wait for?

[admin-james]

Hi, thanks for your post. I'm so glad you asked this because I spent a very long time last month researching these exact questions.

Metastable technetium-99 (Tc-99m) is a man-made radioisotope used as a tracer in a wide variety of diagnostic medical procedures. Choletec (BrIDA, MEB, Mebrofenin) is a "carrier" for the radioactive Tc-99m that makes it go straight to the organ of interest. The Choletec conjugate is not dangerous by itself; only the Tc-99m matters in terms of breastfeeding safety. The radioactive half-life of Tc-99m is fixed at 6 hours and is entirely independent of any influence by Choletec. The International Commission on Radiological Protection (ICRP) and the American Academy of Pediatrics do not specifically mention Choletec in their breastfeeding safety recommendations for Tc-99m. Therefore, I will present the most conservative, worst-case scenario.

Radiation exposure is measured in milli-Sieverts (mSv). The average American adult is exposed to 3.1 mSv per year from natural sources and an additional 3.1 mSv from man-made sources (primarily routine medical procedures). Taking a cue from the ICRP, most safety-minded organizations agree that infants should be exposed to no more than 1 mSV at a time from any given event or procedure. In order to expose your infant to <1 mSv total from your HIDA scan, you should:

Pump and discard once, right when you get home. After that, pump and *store* your breastmilk for 30 hours after the procedure. The Tc-99m continues to decay at the same rate regardless of whether it's in your body or in a bottle, frozen or room-temp. At 30 hours (= 5 Tc-99m half-lives), all of the batches that you put away during that time will be usable and minimally radioactive. The lab may be willing to test your milk for residual radioactivity if you are still concerned. The American Academy of Pediatrics and the US Nuclear Regulatory Commission do NOT recommend any form of close contact (closer than 0.1 cm) isolation to achieve an infant exposure of < 1 mSv. However, the close contact recommendations are based on a mathematical model that assumes women hold their babies for about 35 minutes out of every hour while practicing a typical pattern of breastfeeding. We advise avoiding *extended* close contact, such as co-sleeping or carrying the baby in a sling, for the first 24 hours after the procedure.

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD

[summermess]

HIDA Scan

Also:

how long should I wait to breastfeed infant after Hida scan is done?

[admin-james]

We advise that you use formula or previously pumped milk for 30 hours after the procedure. Pump and store your milk during that time. The milk that you pumped during the 30 hour period will be safe to use after that time is over.

[hope4prdse]

My daughter is 5 yrs old and still nursing for comfort. I'm sure she gets a few drops of milk when she nurses, but not much. I have an appt to get a HIDA scan. Should I worry about this for her?

[admin]

Hope4prdse:


There is nothing to worry about following a HIDA scan. Recommendations should include a brief interruption of breastfeeding. Some authorities do not recommend interruption, but depending on the dose of Technetium, a waiting period of 12-24 hours would preclude most exposure to this radioactive Technetium. Choletec would be rapidly eliminated and poses no risk. Sincalide has a half-life of 1.3 minutes and would not pose a risk at all after a brief waiting period.

Tom Hale