- What is the level of the mother’s exposure to different types of radiation?
- Will breastfeeding raise the level of exposure in the baby?
- Are medications taken to reduce the effects of exposure, notable potassium iodide (KI), likely to pass through the mother’s milk to a degree that the baby could suffer from toxicity?
- Is there a safe, alternative food source for the baby? This generally means clean water and formula, or a supply of solid foods for an older baby. A good supply of water, needed both to mix with powder and to wash bottles, is often difficult to come by after a disaster. Both the powdered milk and the water would have been stored in a closed container to prevent exposure to radiation. A heat source might be needed to sterilize the water used to mix the formula.
Recommendations for Breastfeeding after Radiation Exposure
Neonatologist Kathleen Marinelli MD, IBCLC, FABM, a Board member of the Academy of Breastfeeding Medicine, and Chair of the ABM Protocol Committee goes into detail about the types of exposure and their effect on the lactating mother and nursing baby on the ABM blog.
Marinelli’s conclusions are based on recommendations by Dr. Ruth Lawrence, an expert both in toxicology and breastfeeding medicine:
- The greatest risk of exposure is to radioactive iodine, which gets into the thyroid and can lead to cancer. Exposure can be prevented with the appropriate dosage of potassium iodide (KI) for both the mother and baby. The mother should get one daily dose until she and the baby can be moved to a safe location. The baby should get only one direct dose of KI calculated to the baby’s weight, because a higher dose increases the baby’s risk of hypothyroidism. Babies’ thyroid function should be monitored to make sure they are not getting too much iodine from their mother’s milk.
- Infant are particularly vulnerable to radiation and should get priority, along with their mothers, for sheltering and evacuation.
- Up to 90% of external radiation exposure can be prevented by removing clothes and washing the skin with soap and water.
- If potassium iodide (KI) is not available, and a safe alternative food source is available, the baby should receive formula until the baby can be treated with KI to prevent contamination via the mother’s milk. Water in the area may also be contaminated with radiation, in which case there is no advantage to formula feeding and many disadvantages, including increased risk of infection.