Is Gallium Citrate Ga 67 safe while breastfeeding?

Summary of use during breastfeeding

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 intravenous 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] Note that guidelines are based on theoretical considerations following intravenous administration. One small study indicates that interruption of breastfeeding might not be necessary when Ga 67 citrate is given orally.

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]

Effects on the breastfed infant

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

Effects on milk supply

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

Levels in milk

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]

A breastfeeding patient provided 5 samples of expressed breastmilk from 8.6 to 93.5 hours after administration of 6.8 MBq 67Ga-citrate orally. Total estimated activity ingested by the infant with no interruption of breastfeeding was 27 kBq resulting in effective dose to a 1-year-old of 33 mSv. Results were compared to a second case from another site, from two breastmilk samples provided at 7.7 hours and 82.3 hours, with good agreement. The investigators felt that the study confirms the dose to a breastfeeding infant is very low after oral administration to the mother, and significantly less than 1 mSv, from 67Ga-citrate ingested for colonic transit studies with no interruption of breastfeeding.[9]