Last update Jan. 14, 2021

Scintigraphy

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

A diagnostic image test in which substances labeled with radioactive isotopes (radionuclides) are introduced into the body to explore various organs.

The exposure of the infant to radiation will depend on the time that the radionuclide remains in the body (biological half-life or elimination half-life, which is variable according to the substance marked by the radionuclide and can vary between individuals), on its radioactive or physical half-life that is constant and, finally, on the concentration it reaches in milk.

The times for stopping breastfeeding or avoiding close contact have been calculated by means of measurements so that the infant is exposed to a maximum of 1 millisievert (1 mSv = 0.1 rem) of radiation (ARSAC 2019, ICRP 2008, Howe 2008, Stabin 2000). They can be seen, for each radionuclide in ARSAC 2019 p51, ICRP 2008 p163 and US.NCR 2008 tab U.3 and on this website.

For reference, an adult receives between 3 and 6 mSv per year from environmental radiation according to the region where they live, plus an average of 3 mSv for medical examinations and there are places in the world where exposure reaches 70 mSv per year without harmful effects (Goodman 2012).

If you do not want any radiation, you have to stop breastfeeding for 5 to 10 radiological half-lives of the radionuclide used (consult each radionuclide in this website).

In the event of having to interrupt breastfeeding after the exploration, it is recommended to express milk and offer, instead, milk previously expressed and stored in the refrigerator before the test (ARSAC 2019, Amir 2011, ICRP 2008, Moretti 2000).
The milk expressed after the test can be frozen and used after 10 radioactive half-lives of the corresponding isotope (Hale 2017, page 2019).

There are guides to know whether or not to avoid close contact with the infant (Mountford 1999)

Consult the specific radiopharmaceutical used and try to make it the shortest half-life.


See below the information of this related group:

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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References

  1. ARSAC. Administration of Radioactive Substances Advisory Committee. Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources. Section 7 Conception, Pregnancy and Breastfeeding, p. 53-58. ARSAC Support Unit. Centre for Radiation, Chemical and Environmental Hazards. Public Health England. 2020 Consulted on Dec. 4, 2023 Abstract Full text (link to original source) Full text (in our servers)
  2. Johnson HM, Mitchell KB; Academy of Breastfeeding Medicine.. ABM Clinical Protocol #34: Breast Cancer and Breastfeeding. Breastfeed Med. 2020 Jul;15(7):429-434. Abstract Full text (link to original source) Full text (in our servers)
  3. Mitchell KB, Fleming MM, Anderson PO, Giesbrandt JG; Academy of Breastfeeding Medicine.. ABM Clinical Protocol #30: Radiology and Nuclear Medicine Studies in Lactating Women. Breastfeed Med. 2019 Jun;14(5):290-294. Abstract
  4. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  5. US.NRC - Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Apéndice U, Tabla U.3. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Draft Report for Comment. Appendix U, Table U.3. NUREG-1556. Vol.9, Rev 3. 2016 Full text (link to original source) Full text (in our servers)
  6. Leide-Svegborn S, Ahlgren L, Johansson L, Mattsson S. Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption. Eur J Nucl Med Mol Imaging. 2016 Abstract
  7. Goodman TR, Amurao M. Medical imaging radiation safety for the female patient: rationale and implementation. Radiographics. 2012 Abstract Full text (link to original source) Full text (in our servers)
  8. US.NRC - Howe DB, Beardsley M, Bakhsh S. U.S. Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Apéndice U, Tabla U.3. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Final report. Appendix U, Table U.3. NUREG-556. Vol.9, Rev 2. 2008 Full text (link to original source) Full text (in our servers)
  9. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Recommendations on breast-feeding interruptions, p. 163-165. Ann ICRP. 2008 Abstract Full text (link to original source) Full text (in our servers)
  10. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  11. Moretti ME, Lee A, Ito S. Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician. 2000 Sep;46:1753-7. Review. Abstract Full text (link to original source) Full text (in our servers)
  12. Mountford PJ, O'Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999 Abstract

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