Calculation of radiation dose to infants from radioactive breast milk and suspensions necessary to constrain dose

Full text: For nuclear medicine patients who are breast feeding an infant, special radiation safety precautions may need to be taken. An estimate of the potential radiation dose to the child from ingested milk must be made, and breast-feeding may need to be suspended until levels of radioactivity in the breast-milk have fallen to acceptable levels. The risk of radiation to the child must be weighed against the benefits of breast-feeding and the possible trauma to both mother and child arising from interruption or cessation of the milk supply. In the United States, the Nuclear Regulatory Commission (NRC) has already published regulations which will necessitate an estimate of the infant's dose from breast milk to be made, in principle, for every breast-feeding patient. There is obviously, therefore, a need to provide a rapid and reliable means of estimating such doses. A spreadsheet template which automatically calculates the cumulative dose to breast feeding infants based on any multi-exponential clearance of activity from the breast milk, and any pattern of feeding, has been developed by the authors. The time (post administration) for which breast-feeding should be interrupted in order to constrain the radiation dose to a selected limit is also calculated along with the concentration of activity in breast milk at which feeding can resume. The effect of changing dose limits, feeding patterns and using individually derived breast milk clearance rates may be readily modelled using this spreadsheet template. Data has been included for many of the most commonly used radiopharmaceuticals and new data can readily be incorporated as it becomes available. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc