Last update Dec. 19, 2018
Very Low Risk
At latest update no published data on excretion into breast milk were found.
It has been used in the pediatric and neonatal age.
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 (ACR 2018 p99, Wang 2012, Rubik 2000, Rofsky 1993).
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 (ACR 2018 p99, Puac 2017, Cova 2014, Quintana 2014, Patenaude 2014, Sachs 2013, Tremblay 2012, Wang 2012, Chen 2008, Newman 2007, Webb 2005).
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 (Puac 2017, Quintana 2014, EMA 2010).
We do not have alternatives for Gadoteridol since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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