MRI with Contrast and Breastfeeding

After consulting with a few different doctors(all having mixed advice on the subject) and doing my own reading to make sure that I could nurse after an MRI I had done yesterday, I made the choice to NOT pump and dump as recommended by the radiologists office. There is weak evidence that supports the pump and dump theory and I for one cannot pump enough for a 24 hour supply. It takes me half a week now days to even pump 20oz(darn you hot weather!!)!

Typically, the MRI nurses and doctor will RECOMMEND(I love that word. It means I get to make the choice to listen to them or go off my gut) that you wait 24 hours before you resume breastfeeding. And that you pump enough milk or supplement in that 24 hours. They recommend you pump and dump(such a waste) for that 24 hour period after the contrast is injected.

The article link below that Ive included in this post pretty much sums up what all the other articles out there are saying. The exchange of contrast to the baby through breastfeeding is extremely low and there for there is no solid reason why a mother should stop breastfeeding after a contrast study.

(http://www.radiology.ucsf.edu/patient-care/patient-safety/ct-mri-pregnancy)

USE OF CONTRAST MEDIA DURING LACTATION

The traditional and standard recommendation is that lactating women who receive intravascular iodinated contrast or gadolinium should discontinue breast-feeding for 24 hours, and the expressed milk during this period should be discarded [1]. The rationale for this recommendation appears weak, for several reasons:

  • Only tiny amounts of iodinated or gadolinium-based contrast medium given to a lactating mother reach the milk. For example, a recent study of 20 lactating women found that less than 0.04% of the maternal dose of intravenous gadolinium passes into the breast milk [2].
  • Only a tiny fraction of iodinated contrast or gadolinium entering the infant gut is absorbed. For example, only 1-2% of oral iodinated contrast is absorbed into the bloodstream [3].

Given these considerations, and in accordance with the results of a comprehensive review by the European Society of Urogenital Radiology, the very small potential risk associated with absorption of contrast medium may be insufficient to warrant stopping breast-feeding for 24 hours following either iodinated or gadolinium contrast agents [4]. A recent review in the New England Journal of Medicine also concluded that iodinated contrast administered to breast-feeding women posed no risk to the infant [5].

Key point: Lactating women who receive iodinated contrast or gadolinium can continue breast feeding without interruption.

References

  1. Omniscan package insert, Nycomed, Princeton, NJ.
  2. Kubik-Huch RA, Gottstein-Aalame NM, Frenzel T, et al. Excretion of gadopentetate dimeglumine into human breast milk during lactation. Radiology 2000; 216: 555-558.
  3. Mutzel W, Speck U. Pharmacokinetics and biotransformation of iohexol in the rat and the dog. Acta Radiol Suppl. 1980; 362: 87-92.
  4. Webb JA, Thomsen HS, Morcos SK; Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol 2005; 15: 1234-1240.
  5. Ito S. Drug therapy: Drug therapy for breast-feeding women. N Engl J Med 2000; 343: 118-126.

3 thoughts on “MRI with Contrast and Breastfeeding

  1. Thank you for posting this. I have an MRI coming up and was getting frustrated. The place where I’m going said I couldn’t nurse for 48 hours! My pediatrician said I didn’t have to suspend nursing as long as the dye wasn’t radioactive, which gadolinium isn’t. All the research I read supports what you have written and only suggested that if the mother feels uncomfortable she can pump and dump for 24 hours. I’m still a bit worried cause no one wants to do anything that may harm their child, but my daughter is very young and eats quite frequently. It would be so hard to pump enough. I will probably choose to continue nursing.

  2. Hi,

    I was pleased to read your article. The doctor of the mri said to pump and dump for 24 h, but I was concerned that afterwards my daughter doesn’t want to be breastfeeded again. The Dutch websites give contradictive advice, so I’m very happy I found this post!
    Thanks!

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