Radiological contrast media in the breastfeeding woman: a position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy

Abstract

Objectives

Breastfeeding is a well-recognised investment in the health of the mother-infant dyad. Nevertheless, many professionals still advise breastfeeding mothers to temporarily discontinue breastfeeding after contrast media imaging. Therefore, we performed this review to provide health professionals with basic knowledge and skills for appropriate use of contrast media.

Methods

A joint working group of the Italian Society of Radiology (SIRM), Italian Society of Paediatrics (SIP), Italian Society of Neonatology (SIN) and Task Force on Breastfeeding, Ministry of Health, Italy prepared a review of the relevant medical literature on the safety profile of contrast media for the nursing infant/child.

Results

Breastfeeding is safe for the nursing infant of any post-conceptional age after administration of the majority of radiological contrast media to the mother; only gadolinium-based agents considered at high risk of nephrogenic systemic fibrosis (gadopentetate dimeglumine, gadodiamide, gadoversetamide) should be avoided in the breastfeeding woman as a precaution; there is no need to temporarily discontinue breastfeeding or to express and discard breast milk following the administration of contrast media assessed as compatible with breastfeeding.

Conclusions

Breastfeeding women should receive unambiguous professional advice and clear encouragement to continue breastfeeding after imaging with the compatible contrast media.

Key Points:

• Breastfeeding is a well-known investment in the health of the mother-infant dyad.

• Breastfeeding is safe after administration of contrast media to the mother.

• There is no need to temporarily discontinue breastfeeding following administration of contrast media.

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Abbreviations

HOCM:

high osmolality contrast media

LOCM:

low osmolality contrast media

IOCM:

iso-osmolar contrast media

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Acknowledgments

The scientific guarantor of this publication is Prof. Maria Assunta Cova, Head of Department of Radiology, Cattinara Hospital, University of Trieste, Azienda Ospedaliero—Universitaria “Ospedali Riuniti” Trieste. The authors of this manuscript declare relationships with the following companies: F. Stacul is an Advisory Board member of GE Healthcare and has been invited by GE Healthcare, Bracco to give lectures. All other authors declare that they have no conflict of interest related to the content of this paper. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because the manuscript is a review of the relevant medical literature on the safety profile of contrast media for the nursing infant/child. Methodology: performed at one institution.

R. Davanzo conceived this study as Chair of the Task Force on Breastfeeding, Ministry of Health, Rome, Italy. R. Davanzo and M. Cova coordinated this study.

R. Quaranta, R. Davanzo and F. Stacul collected and analysed data.

R. Quaranta, A.A. Zuppa, R. Davanzo, M. Gregori, P. Guastalla, F. Stacul prepared the draft of the paper. F. Stacul, R. Davanzo, M. Cova, G. Salvatori, C. Fonda, and V. David critically revised the article for important intellectual content.

Between September and November 2013, the Task Force on Breastfeeding, Ministry of Health, Italy and the Executive Committees of the Italian Society of Radiology (SIRM), the Italian Society of Pediatrics (SIP) and the Italian Society of Neonatology (SIN) approved the position paper.

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Correspondence to Roberto Quaranta.

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Cova, M.A., Stacul, F., Quaranta, R. et al. Radiological contrast media in the breastfeeding woman: a position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy. Eur Radiol 24, 2012–2022 (2014). https://doi.org/10.1007/s00330-014-3198-6

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Keywords

  • Contrast media
  • Diagnostic imaging
  • Breastfeeding
  • Lactation
  • Breast milk