Breast-feeding is an interesting question in relation to the mother having had a GBCA injection, with strengths on both sides, risks on both sides, but no certainty. Gd in breast milk has been written about in the literature, but in a time period earlier than the recognition of GDD. Essentially the earlier literature showed that very little Gd comes out in breast milk, and Gd is poorly absorbable in the GI tract. So the consideration changes if the mother has GDD (sick from Gd) or GSC (not sick from Gd). The thinking with a mother with GDD, the neonate has the genetic propensity for the disease as well, so more thought has to be given in that setting.
Here is my thinking:
The farther away from the GBCA injection the less Gd is present in the mother's body, which means less is available to come out in breast milk - probably by 6 months extremely, extremely little Gd comes out in breast milk, and on top of that little Gd can be absorbed from the GI tract, as it is not that absorbable by oral route of administration. So probably 3 months out from GBCA injection, and certainly by 6 months, my guesstimate is .001 mcg of Gd would come out in 20 ml of breast milk, and from that maybe .000001 mcg of Gd entering the blood stream of the neonate.
Interestingly, this could readily be quantified (certainly the amount of Gd in breast milk) by sending breast milk to a lab such as Doctor's Data to test for Gd content - which had not been done in the original estimates from a decade or so in the past. This would actually be an interesting study, but probably in my list of studies to do, something like 100 down the list.
On the positive side of breast feeding is the natural health benefits of breast milk, nutrients, immunology, healthy development of all organs, etc.
It is conceivable, when the mother has GDD, since the immune system seems to require being mature to develop GDD, administering Gd in a tiny amount to a new born/infant could conceivably act as an immunization against GDD in the future (since the child would genetically be at risk for GDD if you have GDD), like any other childhood immunization. This is highly conjectural, and I do not advocate immunizing against GDD with Gd administration in the neonatal period/childhood. What is definite though is Gd does go to bone relatively avidly in developing children.
Overall I think the value of breast milk outweighs the risks. I would not find fault though, if a mother with GDD would feel less worried if she started breast feeding at least 3 months after the development of GDD from a GBCA injection she received.
Richard Semelka MD Consulting
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