General considerations
It is important to complete an individual risk assessment for your patient and to apply the principles of prescribing in breastfeeding when looking at the available information and making treatment decisions.
This article includes the most commonly used contrast agents. Other agents are available. Contact our specialist service for further advice.
Recommendations
Although there is limited published evidence about the use of amidotrizoate, barium, iodinated, and gadolinium-based contrast agents in breastfeeding, significant transfer into breast milk is not expected due to the properties of these agents. In addition, their poor oral bioavailability means that they are unlikely to be absorbed from breast milk in clinically significant amounts, and therefore unlikely to cause side effects in breastfed infants.
No interruption to breastfeeding is necessary following the use of the most commonly used agents included here.
This advice is also supported by the Royal College of Radiologists and Society of Radiographers.
Specific recommendations
Contact us
Get in touch with the UK Drugs In Lactation Advisory Service (UKDILAS), our specialist breastfeeding medicines advice service if you need support in the following situations:
- you need further advice
- the contrast agent in question is not included here
- the infant is unwell or premature
- multiple medicines are being taken
About our recommendations
Recommendations are based on published evidence where available. However, evidence is generally very poor and limited, and can require professional interpretation. Assessments are often based on reviewing case reports which can be conflicting and lack detail.
If there is no published clinical evidence, assessments are based on: pharmacodynamic and pharmacokinetic principles, extrapolation from similar drugs, risk assessment of normal clinical use, expert advice, and unpublished data. Simulated data is now increasingly being used due to the ethical difficulties around gathering good quality evidence in this area.
Bibliography
Full referencing is available on request.