Need to stop BFing for a week, how do I do this??

[chars mum]

Hello,
I need a medical procedure during which a specific chemical is used and may get into my breastmilk.  My doc has advised that I should not breastfeed for at least a week to be safe.  My LO is nearly 7 months old and does not take a bottle or cup yet.  Clearly I need to get her on a bottle asap; however I'm looking for advice regarding what I should be doing myself to keep up my milk supply as I would like to resume BFing afterwards.  Can anyone help me?

[Samuel's mum]

Are you talking about a radioactive isotope or a scanning agent? Would you mind being specific about the medication?
Please don't assume that your doctor has all the facts at his/her fingertips on this one for a start. I strongly advise you to speak to a lactation consultant or get a second opinion as they are very very very few instances where breastfeeding friendly alternatives cannot be found or whether indeed a mother does need to give up breastfeeding for so long. So few medications would remain in the milk so long. A thyroid scan using a radioactive idodine would mean only 24 hours stopping for example.
Here's some info by a doctor expert in breastfeeding.
http://www.kellymom.com/newman/09a-drugs_and_bf.html

If it is the case you need to give up then you would be best to hire a hospital grade double electrical pump.

But you will be amazed how often women are wrongly advised they need to give up as doctors are often uninformed about breastfeeding and understandably want to be cautious. If you do need to give up it may be for considerably less time than 7 days.

[Jennerific]

just marking my place b/c my LO is also 7 months old & i have to stop breastfeeding soon so am here to see what advice you get

[chars mum]

I have a very nasty and painful verruca on the ball of my foot that has not responded to normal treatment and is now growing.  The procedure requires a local anesthetic then the verruca excised and phenol applied to the site.  Not sure of the half life of phenol as it varies depending on the solvent.  No studies out there that I can find either.  You're right, the week is solely precautionary.  The alternative is laser removal which will cost a lot more and would also require quite a bit of traveling...so if I can get the former procedure done safely here, then I would prefer it. Additionally, I was hoping to start weaning to a bottle or cup soon anyways but was hoping to still BF a couple times a day for another few months, until I return to work in Sept.
Thanks for the link, I will check it out! 

[Samuel's mum]

This is Dr Thomas Hale talking about phenol in the context of a face peel (ouch):

http://66.230.33.248/discus/messages/53/1128.html

Phenol is well absorbed transcutaneously. If high concentrations were to be used, it would be a problem because this stuff could easily penetrate into human milk. In addition, phenol is highly toxic, corrosive, etc. Its nasty stuff.

I guess it all depends on the concentration in the peel. If its just a minor component I wouldn't worry, but if its > 1%, I'd be very uncomfortable about breastfeeding. A 24 hour washout period would be suggested after the peel is removed

.

Hope treatment goes well.

[chars mum]

Thank you so much for the information, sounds like really nasty stuff!  I will find out the concentration used and ask Dr. Hale about washout period for my particular case.   

[Samuel's mum]

He's not taking new questions on his forum right now due to spamming. But you could try contacting him directly.
Yeah, it sounds pretty strong stuff, doesn't it!

[chars mum]

Checked out Dr. Hale's website and he is now taking questions from health care professionals only (suppose I qualify as am paramedic but not sure if same in US).  I know it is asking a lot but is there any chance you could ask him on my behalf?  The quote you posted speaks of a 1% solution, the concentration of phenol used for my procedure is around 89%, think the half life would be same, in which case the stated 24 hour washout would also be the same I think but would really like to know for sure.  My podiatrist said that from what he has found, 24 hours would be fine but I am really nervous and would greatly appreciate another opinion.  I will also try to contact Dr. Jack Newman and see if he knows anything about the issue.  Thank you kindly!

[Samuel's mum]

I did register for an account on Hale's site but got a message about spammers and until he can assess all new people he won't allow me to post. He's been health care professionals only forever.
I will put a link here if the situation changes. Sorry!

I would perhaps try and get an opinion from a lactation consultant too.

[chars mum]

Thank you anyways...will keep an eye open in case you do manage to get thru to him.
Perhaps will try Public Health dept, see if they have any info.

[chars mum]

Hello again!
I e-mailed Dr. Jack Newman and the following was his reply:
"You have been misinformed.  You don’t have to interrupt breastfeeding at all.  This is being put on your skin.  The chances of absorbing any significant amount of phenol into your blood is very very small.  The chances of any getting into your milk are vanishingly small.  Please educate the podiatrist, who obviously doesn’t know what it is to try to interrupt breastfeeding in a 7 month old."
I am soooo confused!!!  First my Podiatrist says a week, then he says 24 hours, now Dr. Newman says no need to stop!  I want to trust him but am scared about the entire thing.  Now I need a third opinion!

[Samuel's mum]

GREAT NEWS!!
I just had a brainwave and phoned a special helpline we have in the UK (doh - why didn't I do this before - sorry) and spoke to these people:
http://www.breastfeedingnetwork.org.uk/drugline.html
The pharmacist/ breastfeeding supporter I spoke to says NEWMAN IS RIGHT!! Phenol when applied on the foot is done in much smaller quantities than Hale was talking about (she was familiar with his reference). She also said - and this bit made total sense - the skin of the surface of the foot is effectively dead and without the sort of blood supply you are talking about in other parts of the body so the transfer to blood is teeny tiny let alone the transfer to milk. She was completely relaxed and confident in saying DO NOT STOP FEEDING - not even for an hour. She said even if it wasn't the sole of your foot (where blood supply really is minimal) you still don't need to stop feeding.

So based on that conversation if I was in your shoes I would not stop feeding at all. If your podiatrist needs to know explain you have consulted Newman and this UK specialist helpline! Yay!

[chars mum]

Yes, am very very very pleased!  Thank you for calling the helpline, feel much better knowing more than one person is saying all will be OK.  I sent Dr. Newman another e-mail mentioning that the phenol will be applied after verruca excised and asked it this would give more access to my bloodstream.  His response was that even if it were injected intravenously, the amount that may enter the milk is nothing to worry about.  He also sent me a draft of one of the chapters entitled Drugs and Breastfeeding from his book.  Have read it over, very informative and reassuring. 
BIG SIGH OF RELIEF!!! 

[Samuel's mum]

  He is such a helpful guy - really goes that extra mile.
Why not print a little A4 sheet out for your podatrist? You may prevent future babies being weaned unnecessarily....

[binxyboo]

Dr Jack Newman rocks!!!!

He has helped me so much with issues I have had, he really does go the extra mile and beyond.

That is great news!