Is it safe to continue breastfeeding after receiving contrast agents, such as iodine-based (e.g. iohexol) or gadolinium-based (e.g. gadobutrol) agents, during medical imaging procedures?

Breastfeeding After Contrast Agent Administration

Breastfeeding can safely continue without interruption after receiving both iodinated and gadolinium-based contrast agents used in medical imaging procedures. 1, 2

Safety of Contrast Agents During Breastfeeding

Iodinated Contrast Agents

• Less than 1% of iodinated contrast is excreted into breast milk and absorbed into the infant's gastrointestinal tract 1
• The American College of Radiology confirms that breastfeeding is safe after administration of iodinated contrast media to the mother 2
• No temporary discontinuation of breastfeeding or expression/discarding of breast milk is necessary 3

Gadolinium-Based Contrast Agents

• Only tiny amounts of gadolinium-based contrast agents enter breast milk, with minimal absorption from the infant's gastrointestinal tract 4
• Most gadolinium-based agents are considered safe during breastfeeding 2
• Important exception: Gadolinium agents at high risk of nephrogenic systemic fibrosis (gadopentetate dimeglumine, gadodiamide, gadoversetamide) should be avoided in breastfeeding women as a precaution 3

Clinical Recommendations

For Healthcare Providers

1. Provide clear, evidence-based information to breastfeeding mothers about contrast safety
2. Reassure mothers that they can continue breastfeeding immediately after receiving contrast media 3, 5
3. Document the type of contrast agent used in the medical record
4. For gadolinium agents, verify that high-risk agents (mentioned above) are avoided when possible

For Breastfeeding Mothers

• No need to "pump and dump" breast milk after receiving contrast media 3
• No need to interrupt breastfeeding schedule
• Continue normal breastfeeding immediately after the imaging procedure

Special Considerations

Contrast During Pregnancy vs. Breastfeeding

• While contrast agents require careful consideration during pregnancy (especially gadolinium), the safety profile is much more favorable during breastfeeding 1, 2
• Gadolinium crosses the placenta during pregnancy but poses minimal risk during breastfeeding 2

Common Misconceptions

• Many healthcare professionals incorrectly advise temporary discontinuation of breastfeeding after contrast administration 3
• This outdated practice is not supported by current evidence and can disrupt breastfeeding unnecessarily

Conclusion

The minimal amount of contrast media that enters breast milk poses negligible risk to the breastfeeding infant. The benefits of continued breastfeeding far outweigh any theoretical concerns about contrast exposure through breast milk 3, 6, 5.