Is (Gadolinium-Based RMI Contrast Agents) compatible with breastfeeding? Do we have alternatives for (Gadolinium-Based RMI Contrast Agents)?

(Gadolinium-Based RMI Contrast Agents)

July 21, 2017 (Very Low Risk)

The various contrast media that are gadolinium derivatives and used for explorations with Magnetic Resonance Imaging (MRI) are considered compatible with breastfeeding because they are quickly eliminated (elimination half-life of less than 2 hours). They undergo very little metabolic changes and are virtually non-absorbable orally. They are structurally very similar to each other. Some have been shown to have no or minimal excretion into the milk.

Less than 0.04% of the dose given to the mother ends just going into the milk.
Due to its low oral bioavailability, intestinal absorption should be less than 1% of the dose took by the infant.
The maximum dose received by the infant is considered less than 0.0004% of the maternal dose, which is much less than the dose administered to a newborn infant who undergoes a MRI scan.

Most Radiology Scientific Societies agree that after an MRI scan is not necessary to temporarily stop breastfeeding.

Some authors recommend avoiding the use on lactating women of some Gadolinium contrast media that would pose a high risk for developing Systemic Nephrogenic Fibrosis, especially in the neonatal period, like gadoversetamide, and gadodiamide dimeglumine, by using instead low-risk ones like gadoterate, gadoteridol and gadobutrol.


See below the information of this related group:

Alternatives

We do not have alternatives for (Gadolinium-Based RMI Contrast Agents) since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

References

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  2. Cova MA, Stacul F, Quaranta R, Guastalla P, Salvatori G, Banderali G, Fonda C, David V, Gregori M, Zuppa AA, Davanzo R. 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. 2014Abstract
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