Radiocontrast guidelines for breastfeeding mothers in our hospital

[Terry]

Dear Dr. Hale,
I am hoping to compile guidelines for radiocontrast agents for our hospital. We just had a mother
told by the radiologist she must pump and discard for 48 hours after receiving Iopamidol. I have your
'Recommendations for Radiocontrast Agents | InfantRisk Center Source: infantrisk.com ' and I also talked to Colleen today at infantrisk, and I have also read your forums about cessation of breastfeeding for 4-5 hours-(depending on the half-life), then pumping and discarding once.
My question is that the ACR says these agents are safe to continue breastfeeding, but then ACR goes on to say that if the mother is concerned she can pump and discard for 24 hours. Is there any reference I can use to cite your 2 half-lives guideline?

Thank you.

[admin]

Terry:

No reference that I know of. We know from several published papers that the transfer of radiocontrast agents into human milk is low to begin with, but some small amount may pass into milk anyway. That present in milk from prescribing information suggests that its not orally bioavailable in humans.

But because some people do have allergic reactions to the IV use of these drugs, I simply added the pump and discard once to try and reduce any possible complication. This is the reason for waiting several half-lives, to reduce almost any risk from exposure to this family of drugs.

In reality, its just a safety factor and may not at all be necessary. But I have no reference for it.


Tom Hale Ph.D.