Breastfeeding and potential exposure to chemo patient's urine?

[nurse_shelly]

I'm currently breastfeeding my three months old. I was taking care of a patient on chemo precautions for taking arimidex earlier today. I was helping her to the bathroom and she accidentally had an incontinent episode and urinated on the floor. I'm pretty sure I accidentally stepped on it, but I'm not 100% sure if any urine got on top of my shoes and possibly soaked in because the top of my shoes are a mesh/breathable material.  I'm very hesitant to breastfeed and thinking of pumping and dumping. How long is it OK before I can breastfeed again? I also didn't even think about it, but I flushed the toilet with her urine. Is it possible that her urine droplets could have gotten into the air and I breathed it in? 

[DavidFR, BSN, MSN, RN]

There's a detailed policy document made out by a British hospital here where you might find some useful information.

https://www.england.nhs.uk/mids-east/wp-content/uploads/sites/7/2018/04/policy-on-handling-chemotherapy-during-pregnancy-v2.pdf

Where I work pregnant and breastfeeding nurses handle chemo and with the standard precautions, which are strict where I work, there doesn't seem to be an issue. That said, if a pregnant colleague expresses concern the rest of us tend to be sympathetic and do all we can to re-organise so that that nurse can avoid chemo. I think exposure from the incident you describe is probably unlikely, but I understand how concerning this must be for the pregnant or breastfeeding nurse. I did once get a spray of cisplatin in the face, fortunately not in ther eyes. I came to no harm but the initial worry was there, and as a man I didn't have to worry about being potentially pregnant!

Has your facility got a specific policy in place such as the British hospital above? Is there a sympathetic manager you can discuss your conerns with? What does your midwife and/or obstetrician think?