Breastfeeding After CT with Iodinated Contrast
Yes, a lactating mother can and should continue breastfeeding immediately after undergoing a CT scan with iodinated contrast—there is no need to interrupt breastfeeding or discard breast milk. 1
Evidence Supporting Continued Breastfeeding
The American College of Cardiology provides the most direct guidance on this issue:
Less than 1% of intravascular iodinated contrast is excreted into breast milk, and less than 1% of that amount is absorbed by the infant's gastrointestinal tract. 1 This results in negligible infant exposure.
Lactating women do not need to discontinue breastfeeding after receipt of intravascular iodinated contrast. 1
The American Association for the Study of Liver Diseases reinforces this position:
- Breastfeeding after iodinated contrast is considered safe because less than 0.01% of CT contrast is present in breast milk, and even less is absorbed by the infant's gastrointestinal tract. 1
Clinical Implementation
The mother can resume breastfeeding as soon as she has recovered from the procedure and feels alert enough to safely hold her infant. 2 There is no waiting period required.
Key Points for Patient Counseling:
No "pump and dump" protocol is necessary—this outdated advice should be abandoned. 3, 4
The infant receives essentially no contrast exposure through breast milk due to the double barrier of minimal excretion into milk and minimal gastrointestinal absorption. 1
Modern non-ionic iodinated contrast agents have no effect on the thyroid gland and pose no risk to the nursing infant. 1
Important Distinction: Nuclear Medicine vs. CT Contrast
This guidance applies specifically to iodinated CT contrast, NOT to radioactive iodine or other radiopharmaceuticals used in nuclear medicine studies. 1, 5
For nuclear medicine studies with [18F]FDG PET, contact between mother and child should be restricted for 4 hours after injection to reduce radiation exposure from the mother herself (not from breast milk). 1
Radioactive iodine (I-131) requires complete cessation of breastfeeding due to accumulation in breast tissue and significant infant risk. 5
Common Pitfall to Avoid
Healthcare providers frequently give incorrect advice to temporarily discontinue breastfeeding after contrast imaging. 3, 4 This misinformation can undermine breastfeeding success and should be actively corrected. The evidence unequivocally supports immediate continuation of breastfeeding after iodinated CT contrast administration. 3, 6, 4