American Academy of Pediatrics

TABLE 3

Radioactive Compounds That May Require Temporary Cessation of Breastfeeding: Recommendations of the International Commission on Radiologic Protection

Compound	Examples	Example of Procedures	Recommended Time for Cessation of Breastfeeding	Comments
¹⁴C-labeled	Triolein, glycocholic acid, urea	Helicobacter pylori breath test	None	No approved US products
^99mTc-labeled	DMSA, DTPA, phosphonates (MDP), PYP, tetrofosmin	Multiple: imaging of kidney, bone, lung, heart, tumors	0 to 4 h, as long as no free pertechnetate	Consider discarding at least 1 meal after procedure
	Microspheres, pertechnetate, WBC		12–24 h	Range depends on dose
	Sulfur-colloids, RBC in vivo		6 h
I-labeled	¹²³I, ¹²⁵I or ¹³¹I-iodo hippurate	Thyroid imaging	12 h	Note: whole-body irradiation with ¹³¹I requires prolonged cessation
Others	¹¹C- ¹¹N or ¹¹O-labeled	PET scans	None	Short physical half-life
	⁵⁷Co-labeled vitamin B₁₂	Schilling test	24 h	Pomeroy 2005¹¹⁹
	¹⁸F-FDG	PET scans	None, first feeding should be expressed breast milk to avoid direct contact¹²⁰	Use alternatives for 10 half-lives (10×109 min= 18 h)^a
	⁵¹Cr-EDTA	Renal imaging	None
	^81mKr-gas	Pulmonary imaging	None	No approved US products
	⁸²Rb chloride	PET scan of myocardium	May resume 1 h after last infusion	Half-life 75 s^a
	¹¹¹In-octreotide	SPECT, neuroendocrine tumors	None
	¹¹¹In -WBC		1 wk	Depends on dose
	¹³³Xe	Cardiac, pulmonary, and cerebral imaging	None	Half-life 5 d^a

Compound	Examples	Example of Procedures	Recommended Time for Cessation of Breastfeeding	Comments
¹⁴C-labeled	Triolein, glycocholic acid, urea	Helicobacter pylori breath test	None	No approved US products
^99mTc-labeled	DMSA, DTPA, phosphonates (MDP), PYP, tetrofosmin	Multiple: imaging of kidney, bone, lung, heart, tumors	0 to 4 h, as long as no free pertechnetate	Consider discarding at least 1 meal after procedure
	Microspheres, pertechnetate, WBC		12–24 h	Range depends on dose
	Sulfur-colloids, RBC in vivo		6 h
I-labeled	¹²³I, ¹²⁵I or ¹³¹I-iodo hippurate	Thyroid imaging	12 h	Note: whole-body irradiation with ¹³¹I requires prolonged cessation
Others	¹¹C- ¹¹N or ¹¹O-labeled	PET scans	None	Short physical half-life
	⁵⁷Co-labeled vitamin B₁₂	Schilling test	24 h	Pomeroy 2005¹¹⁹
	¹⁸F-FDG	PET scans	None, first feeding should be expressed breast milk to avoid direct contact¹²⁰	Use alternatives for 10 half-lives (10×109 min= 18 h)^a
	⁵¹Cr-EDTA	Renal imaging	None
	^81mKr-gas	Pulmonary imaging	None	No approved US products
	⁸²Rb chloride	PET scan of myocardium	May resume 1 h after last infusion	Half-life 75 s^a
	¹¹¹In-octreotide	SPECT, neuroendocrine tumors	None
	¹¹¹In -WBC		1 wk	Depends on dose
	¹³³Xe	Cardiac, pulmonary, and cerebral imaging	None	Half-life 5 d^a

DMSA, dimercaptosuccinic acid; DTPA, diethylenetriaminepentaacetate; EDTA, ethylenediaminetetraacetic acid; FDG, fludeoxyglucose; PET, positron emission tomography; PYP, pyrophosphate; RBC, red blood cell; SPECT, single-photon emission computed tomography; WBC, white blood cell.

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