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Breastfeeding after CT and MRI scans

Virtually every day I get messages from mothers and health visitors querying whether mothers can continue to breastfeed after CT and MRI scans. I was told that the national guidelines had been updated some years ago to align with RANZR guidelines . Sadly guidelines dont seem to have been updated by all radiology departments from my experience despite an update on 25.1.22 (see below)

I was lucky enough to work with Dr Gabrielle Cronin on this paper which was published in the Irish BMJ

https://rb.gy/opvtzx
http://imj.ie/ct-and-mr-contrast-in-breastfeeding-mothers-is-current-practice-evidence-based/?fbclid=IwAR3k_GEfKmTeSdLDL7ZiClwZjQ9yIo1Q1gNhXaZ2OXFjvMhV7nAK7fINCtU

Most mothers are advised to stop breastfeeding for 24 hours but there is no evidence for this as most contrast media are not orally bio available and have half lives which do not justify this duration.

On 25 January 2022 this was published by the Society of Radiologists :

https://www.sor.org/news/sor/sor-issues-joint-statement The Society has issued guidance to reassure patients after recent research showed a lack of awareness among imaging teams on the most up-to-date evidence and guidance for breast-feeding patients who require a CT or MRI with contrast.The current Royal College of Radiologists (RCR) guidance published in 2019 relating to MR states:While no special precaution or cessation of breastfeeding is required the continuation or cessation of breastfeeding for 24 hours should be at the discretion of the lactating mother in consultation with the clinician.The SoR and RCR refer to the guidance published by The Royal Australian and New Zealand College of Radiologists (RANZCR) regarding CT contrast which says:Cessation of breast feeding or expression and discarding of breast milk after iodinated contrast media administration are not required.The Breastfeeding Network has summarised the advice of a number of expert organisations across the globe which is available on their website .The very small potential risk associated with absorption of contrast medium is considered insufficient to warrant suspending breastfeeding for any period following iodinated contrast agent administration.It is the view of the RCR and SoR that patients who wish to continue breastfeeding after being administered with contrast agent should be able to do so as there is no evidence of risk to the baby/child.Position statement – for patients. The Society of Radiographers (SoR) and the Royal College of Radiologists (RCR) are aware of conflicting opinions about whether patients who are administered with contrast agents – usually as part of a CT or MRI scan– can breast feed as part of their normal routine.It is the view of both the RCR and the SoR that patients who wish to continue breastfeeding after being administered with contrast agent – usually given in advance of a CT or MRI scan – should be able to do so as there is no evidence of risk to the baby/child. If you have any concerns please, speak with your radiographer or radiologist.

More information

https://www.breastfeedingnetwork.org.uk/ct/ https://www.breastfeedingnetwork.org.uk/mri/

RANZR guidelines