Review of the literature shows no evidence to suggest that oral ingestion by an infant of the tiny amount of gadolinium contrast agent excreted into breast milk would cause toxic effects. Therefore, the available data suggest that it is safe for the mother and infant to continue breast-feeding after receiving such an agent.
The Committee on Drugs and Contrast Media of the American College of Radiology (ACR) has discussed this issue extensively and has prepared the following summary and recommendations:
The literature on the excretion into breast milk of gadolinium-based MRI contrast agents and the gastrointestinal absorption of these agents from breast milk is very limited. A review of the literature, however, reveals important facts: (1) less than 1% of the administered maternal dose of contrast agent is excreted into breast milk; and (2) less than 1% of the contrast medium in breast milk ingested by an infant is absorbed from the gastro-intestinal tract. Therefore, the expected dose of contrast medium absorbed by an infant from ingested breast milk is extremely low.
If the mother remains concerned about any potential ill effects, she should be given the opportunity to make an informed decision as to whether to continue or temporarily abstain from breast-feeding after receiving a gadolinium contrast agent. If the mother so desires, she may abstain from breast-feeding for 24 hours with active expression and discarding of breast milk from both breasts during that period. In anticipation of this, she may wish to use a breast pump to obtain milk before the contrast study to feed the infant during the 24-hour period following the examination.
*Excerpted from the American College of Radiology, Manual on Contrast Media,Version 6, 2008 – full version available at www.acr.org