From the Guidelines
Breastfeeding can be continued without interruption after an echo contrast study, as the contrast agents do not reach breast milk in significant amounts. The echo contrast agents, such as microbubble contrast agents like Definity, Optison, and Lumason, have a very short half-life (minutes) in the bloodstream and are composed of gases that are rapidly eliminated from the body through respiration 1. The microbubbles are typically destroyed during circulation and the shell components are metabolized or excreted quickly. Additionally, even if minimal amounts were to reach breast milk, they would not be orally bioavailable to the infant as they would be destroyed in the infant's digestive tract. This is further supported by the fact that less than 0.01% of CT contrast is present in breast milk, and even less is absorbed by the infant’s gastrointestinal (GI) tract, as seen with iodinated contrast agents 1. Therefore, no special precautions or temporary cessation of breastfeeding is required after an echo contrast study, prioritizing the well-being and quality of life of both the mother and the infant. Key points to consider include:
- The pharmacokinetic properties of echo contrast agents and their rapid clearance from the maternal circulation
- The minimal transfer of contrast agents to breast milk
- The lack of oral bioavailability of contrast agents to the infant
- The safety of breastfeeding after echo contrast studies, as supported by the American College of Cardiology and the American Heart Association 1.
From the Research
Echocardiogram Contrast Agent and Breast Milk
- The studies 2, 3 suggest that only tiny amounts of iodinated or gadolinium-based contrast medium given to a lactating mother reach the milk, and only a minute proportion entering the baby's gut is absorbed.
- According to 3, the very small potential risk associated with absorption of contrast medium may be considered insufficient to warrant stopping breast-feeding for 24 h following either iodinated or gadolinium contrast agents.
- However, 4 reveals that data concerning the amount of contrast agents in human breast milk as well as contrast medium absorption by the infants' intestine are sparse, and instead, a lot of speculations and incorrect conclusions do exist in the literature.
- The study 5 focuses on the MR imaging characteristics of normal breast tissue and breast cancer in the setting of lactation, but does not directly address the issue of contrast agent reaching breast milk.
- The article 6 discusses the safety of contrast material use during pregnancy and lactation, but does not provide specific information on echocardiogram contrast agents reaching breast milk.
Key Findings
- Breastfeeding is safe after administration of contrast media to the mother 2.
- There is no need to temporarily discontinue breastfeeding following administration of contrast media 2, 3.
- The amount of contrast agents in human breast milk and contrast medium absorption by the infants' intestine are not well studied 4.