From the Guidelines
No, CT contrast agents are not contraindicated in breastfeeding females undergoing CT scans of the face. Breastfeeding can continue normally after receiving iodinated contrast media or gadolinium-based contrast agents. The amount of contrast that enters breast milk is extremely small (less than 0.01% of the administered maternal dose), and of that tiny amount, less than 1% is absorbed by the infant's gastrointestinal tract, as stated in the study by 1. This means the infant receives a negligible systemic exposure. According to the study by 1, breastfeeding after iodinated contrast (or gadolinium) is considered safe. However, if a mother remains concerned, she may choose to express and discard breast milk for 24 hours after contrast administration, though this is not considered medically necessary. The key consideration is the minimal amount of contrast agent that enters breast milk and the negligible absorption by the infant, making it safe to continue breastfeeding after receiving contrast media, as supported by the study by 1.
Some key points to consider:
- The amount of contrast agent in breast milk is extremely small, less than 0.01% of the administered dose 1.
- The absorption of contrast agent by the infant's gastrointestinal tract is negligible, less than 1% of the amount in breast milk 1.
- Breastfeeding can continue normally after receiving iodinated contrast media or gadolinium-based contrast agents 1.
- The American College of Radiology and other medical organizations support the safety of continuing breastfeeding after receiving contrast media, although specific guidelines may vary.
In the context of the patient's dental pain and facial swelling, a CT scan of the face with contrast may be necessary to evaluate her condition, and breastfeeding does not need to be interrupted. The benefits of the diagnostic information obtained from the CT scan outweigh the minimal risks associated with contrast agent exposure to the breastfeeding infant, as indicated by the study by 1.
From the FDA Drug Label
Breastfeeding No human data exist concerning the excretion of iomeprol in breast milk Animal studies have demonstrated that the excretion of iomeprol in breast milk is similar to that of other contrast agents and that these compounds are only minimally absorbed by the gastrointestinal tract of the young. Adverse effects on the nursing infant are therefore unlikely to occur. Stopping breastfeeding is unnecessary.
The use of contrast media, such as iohexol, in breastfeeding females is not contraindicated. According to the drug label, animal studies have shown that the excretion of iomeprol in breast milk is minimal and unlikely to cause adverse effects on the nursing infant. Therefore, stopping breastfeeding is unnecessary 2.
From the Research
Contrast Agents in Breastfeeding Females
- The use of contrast agents in breastfeeding females is a concern due to the potential risk of iodine exposure to the infant 3.
- However, studies suggest that iodinated contrast media seem safe to use in pregnancy and lactation, and it is safe to continue breastfeeding immediately after receiving iodinated contrast 3.
- There is no evidence to suggest that contrast agents are contraindicated in breastfeeding females, but it is essential to weigh the benefits and risks of using contrast media in each individual case.
Safety of Contrast Agents
- Iodinated contrast media have a favorable safety profile, but they can cause adverse reactions 4.
- The risk of carcinogenesis is a potential concern when using CT scans, especially in pregnant and lactating women 3.
- New developments in contrast media, such as iodine-free contrast agents, may provide alternative options for patients with known reactions to low-osmolality contrast media or thyroid disorders 4.
CT Scans with Contrast in Breastfeeding Females
- CT scans with contrast can be valuable tools in diagnosing and evaluating conditions in breastfeeding females, including dental pain and facial swelling.
- However, the decision to use contrast media should be made on a case-by-case basis, considering the potential benefits and risks, as well as alternative imaging options 3, 5.