Contrast media and breastfeeding

Last revised by Andrew Murphy on 23 Mar 2023

Contrast media and breastfeeding is an area of imaging safety that has been investigated for both iodinated and gadolinium-based contrast agents. The current guidelines do not support the cessation of breastfeeding or any special precautions after intravenous administration of these contrast media.

Iodinated contrast media

The plasma half-life of IV iodinated contrast agents is two hours, with ~100% excreted in 24 hours. Contrast agents have poor lipid solubility and <1% of dose enters breast milk. Furthermore <1% of this ingested dose is absorbed by the infant's gastrointestinal system. Therefore the total dose to the infant is <0.01%.

There is a theoretical risk of allergic reaction to contrast from breast milk, but this has never been reported:

  • current guidelines do not support the cessation of breastfeeding after contrast administration
  • a conservative approach, only if the mother remains concerned about any potential effects, may wait 12-24 hours, expressing and discarding milk over that period, but there is no benefit to waiting >24 hours

Gadolinium-based contrast media

The plasma half-life of IV gadolinium-based contrast agents is two hours, with ~100% excreted in 24 hours. It is estimated that <0.0004% of the maternal dose is absorbed by the infant, and it is also thought that any gadolinium in breast milk is in a stable chelated form:

  • current guidelines do not support the cessation of breastfeeding after contrast administration
  • a conservative approach, only if the mother remains concerned about any potential effects, may wait 12-24 hours, expressing and discarding milk over that period, but there is no benefit to waiting >24 hours

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