One for the dentists: Re extractions and BF - urgent advice please.

[pootros]

I had a bit of a stress today.

Short version: If you had dental amalgam extracted would you advise to stop BF for a while? 

Longer version: 
 Had to take my 4m fully breastfed dd in with me to dentist, as had letter saying I needed to see them. Was asked " are you here for a filling? ", to which I replied, "yes, but do I need to have it now?". Answer was - how long's a piece of string, and that I might get an abcess at some point. ( I'd seen her colleague for another preg related tooth prob who'd said he'd hold tight - but I didn't say this - stupid me)So she started. Halfway thru - drills etc in my mouth, she says - "It's very far back. I need to use amalgam." At the end she says - "does baby take the bottle? I suggest you avoid breastfeeding for a day. " and then asked me to come back for a checkup! ( would have been nice if this was the other way round...but I'm not one for telling people their jobs.) 
Only at this point did I twig that amalgam = mercury = not great. I drove home, worried about BF, looked up on tinterweb and straight away found this: Dental mercuryMercury from dental amalgam: looking beyond the averageOccup Environ Med 2005;62:352-353, that seemed to show that it takes 5 months before mercury levels come down after taking away a filling. So I called her up again re her advice to avoid BF for 1 day, and she said - "i glad you phoned, I forgot to ask if you were breastfeeding before doing this, come back and I'll take it out. "
So an hour later there I was, having the new mercury amalgam filling taken out and replaced with something else, without an assistant there, using a dental dam, no suction and no cold water irrigation. I swallowed loads. 
At the end of the day she calls back and says that her colleagues wouldn't have thought twice about putting in an amalgam. 

So, basically, WTF?!Have I had 2 hits of mercury vapour? IS it a problem or not!?I've looked up FDA and breastfeeding network advice sheet, and toxbase. They all say that old dental amalgams per se don't affect baby via breastmilk. And avoid unecessary dental work while preggers or BF. But should amalgam extractions come with a warning to avoid BF for a day, as my dentist said?
www.ncbi.nlm.nih.gov/pubmed/9539465 The absorption, blood levels, and excretion of mercury after a single dose of mercury vapor in humans, says that it drops slowly after a hit. I appreciate the latter is from the swedish camp who've banned mercury in amalgams.

THanks for your advice. I have given old freezer EBM and formula for the last 3 feeds but am running out of EBM and really want to continue BF if no risk of harm to baby. Would really appreciate any advice. I think I'm going to avoid for a week and then carry on BF, if I can...  

[Davidsmom]

Hi,

Sounds frustrating. There will be lots of comments soon I'm sure from people as mercury/amalgam is controversial even without the breastfeeding issue.

I had a quick look and found this which is not great but may help.

www.nelm.nhs.uk/en/NeLM-Area/Evidence/Medicines-Q--A/Is-it-safe-to-have-amalgam-fillings-placed-or-removed-if-breastfeeding/

Sorry not good at links!

[Davidsmom]

PS you might want to repeat your post in the breastfeeding section. There are some breastfeeding advisors there who might be able to advise.

[pootros]

thanks davidsmom.
am on it - will post my " findings" here x

[pootros]

NHS direct were really good for a basic question on BF and a drug. They used the breastfeeding network resource: www.breastfeedingnetwork.org.uk/

Dr Hale's team in Texas are amazing for the more complicated questions.
www.infantrisk.com/ . They have a helpline.

They answered my questions in keeping with the search I had done ( advice pump and discard for 48-72 hrs post exposure in my case, then continue, as had 2 exposures under less than ideal circs- did I mention the dental dam pinged out of my mouth and the clamp hit the door?!). Not sure what they'd advise if only 1 exposure under good circs - but they would know!

Bottom line - don't have dental work in preg/ BF unless you need it!
Pre existing amalgams - no problems if you leave them be!