Should women pause breastfeeding after contrast injections? Survey reveals vastly different opinions

A new paper highlights stark differences in how different genders perceive the risks to newborns after breastfeeding women receive an injection of iodinated contrast. 

According to the group surveyed for the paper, including 20 breastfeeding women, 21 female and 20 male radiologists, most women feel that they should temporarily cease breastfeeding for 24 hours after receiving a contrast injection, while the majority of men do not believe the break is necessary. 

Although the risk of an adverse reaction to iodinated contrast is minimal in adults, it is important to consider how it could affect an infant, as they are considered more vulnerable to the possible side effects, noted co-authors Sina Lemmenmeier and Ingrid B. Boehm, of Bülach Hospital and University Hospital of Bern, both in Switzerland. 

“Newborns and infants (<3 years old) have an immature intestinal barrier function. Following the oral uptake, substances can pass the intestine barrier and reach the blood stream,” the authors wrote. “Therefore, the amount of iodine absorbed by the baby could be probably significantly higher than assumed.” 

Even among medical organizations, opinions on whether women should temporarily stop breastfeeding after receiving an injection vary. The American College of Radiology’s guidelines take the breastfeeding mother's wishes into heavy consideration and ultimately leave the decision up to the woman. Other organizations, like the European Society of Urogenital Radiology, recommend that women continue to breastfeed after an injection.  

Manufacturers that make iodinated contrast products have differing instructions as well, with some advising women to briefly forego breastfeeding after an injection and others recommending that they continue. 

These latest survey results suggest that the divide in preference is perhaps most pronounced among different genders. Every breastfeeding woman surveyed indicated that there should be a 24-hour break after receiving a contrast injection, while 62% of the female radiologists polled shared the same sentiment. In contrast, 70% of the male radiologists signaled preference for the continuation breastfeeding without pause. 

Research on the subject has also failed to definitively determine the best course of action, the authors noted, highlighting a lack of sufficient human data and inconsistent methodology in the small number of studies currently available.  

As they see it, this lack of data “limits the ability to create guidelines that allow continuing breastfeeding." As such, they conclude that, in this absence, “stopping breastfeeding for 24 [hours] seems to be the safest option."

The study abstract is available in the European Journal of Radiology

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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