Gallium Citrate Ga 67 and Breastfeeding

Summary of use during lactation

Information in this record refers to the use of Ga 67 citrate as a diagnostic agent. Several international guidelines recommend discontinuation of breastfeeding for 3 to 4 weeks or complete cessation of breastfeeding after Ga 67 citrate.[1-5] If the mother wishes to resume nursing, the breasts should be emptied regularly and completely during the period of interruption. If the mother has expressed and saved milk prior to the examination, she can feed it to the infant during the period of nursing interruption.[3,6] The milk that is pumped by the mother during the time of breastfeeding interruption can either be discarded or stored frozen and given to the infant after 10 physical half-lives, or about 33 days, have elapsed.[3,6] Mothers concerned about the level of radioactivity in their milk could ask to have it tested at a nuclear medicine facility at their hospital. When the radioactivity is at a safe level, she may resume breastfeeding. A method for measuring milk radioactivity and determining the time when a mother can safely resume breastfeeding has been published.[7] Mothers who receive a dose less than 190 MBq for an inflammation scan need not refrain from close contact with their infants.[8]

Drug levels in milk and infant serum

Ga 67 decays by electron capture with principal photon energies of 93, 185 and 300 keV, and a physical half-life of 3.26 days.[4] The effective half-life of gallium 67 citrate ranges from 40 to 68 hours.[6,7]

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

References

1. Mattsson S, Johansson L, Leide Svegborn S, et al. Radiation dose to patients from radiopharmaceuticals: A compendium of current information related to frequently used substances. ICRP Publication 128. Annex D. Recommendations on breast-feeding interruptions. Ann ICRP 2015;44:7-321.26069086 PubMed
2. International Atomic Energy Agency. Radiation Protection and Safety in Medical Uses of Ionizing Radiation, IAEA Safety Standards Series No. SSG-46, IAEA, Vienna. 2018. https://www.iaea.org/publications/11102/radiation-protection-and-safety-in-medical-uses-of-ionizing-radiation
3. ARSAC notes for guidance: Good clinical practice in nuclear medicine. Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. 2020. https://www.gov.uk/government/publications/arsac-notes-for-guidance
4. Dilsizian V, Metter D, Palestro C, et al. Advisory Committee on Medical Uses of Isotopes (ACMUI) Sub-Committee on Nursing Mother Guidelines for the Medical Administration of Radioactive Material. Final report submitted: January 31, 2019. 2019. https://www.nrc.gov/docs/ML1903/ML19038A498.pdf
5. Stabin MG. Doses from medical radiation sources. https://hps.org/hpspublications/articles/dosesfrommedicalradiation.html. Accessed Nov 6, 2024.
6. Mountford PJ, Coakley AJ. A review of the secretion of radioactivity in human breast milk: Data, quantitative analysis and recommendations. Nucl Med Commun 1989;10:15-27.2645546 PubMed
7. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: Mechanisms, findings, and radiation dosimetry. J Nucl Med 2000;41:863-73.10809203 PubMed
8. Mountford PJ, O'Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot 1999;50:89-111.10028630 PubMed