Janaki: This particular brand is not among the ones listed in Hale's 1997
edition, but he has an excellent listing under Radiopaque Agents
(otherwise known as radio-contrast agents). He states "Radiopaque
agents....are iodinated compounds......highly iodinated benzoic acid
derivatives. Although under usual circumstances, iodine products are
contraindicated in nursing mothers (due to ion trapping in milk), these
products are unique in that they are extremely inert. In one study,
the amount....secreted in breastmilk was less than 0.5% of the
maternal dose. According to several manufacturers, less than 0.005%
of the iodine is free. These contrast
agents are in essence pharmacologically inert, not metabolized, and are
rapidly excreted by the kidney (80-90% within 24 hours). They are known
to pass unchanged into human milk after IV administration. They are
*virtually unabsorbed after oral administration (<0.1% absorption)*
[emphasis mine]. Most are cleared for pediatric use. Although most
company package inserts suggest that an infant be removed from the breast
for 24 hours, no untoward effects have been reported with these products,
nor any indication of oral absorption by an infant."
So, if this is just one more such agent, which I am sure it is, then the
baby is likely to see 0.5% of maternal dose, of which he would absorb
0.1%, i.e. 0.05% of maternal dose. I'm willing to bet that even one
bottle of abm would confer several orders of magnitude greater risk to
that baby than this contrast agent. Hope you can convince at least the
mother, if not the radiologist. Good luck, Alicia Dermer, MD, IBCLC.
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