I work at a hospital in Washington, DC and had a discussion with the radiologists about this. They understand the literature from ACR, but one radiologist pointed out that the actual package instructions that accompany Omnipaque, a frequently used contrast media, are not as explicit. The instructions state: 

Nursing Mothers
It is not known to what extent iohexol is excreted in human milk. However, many injectable
contrast agents are excreted unchanged in human milk. Although it has not been established
that serious adverse reactions occur in nursing infants, caution should be exercised when
intravascular contrast media are administered to nursing women. Bottle feedings may be
substituted for breast feedings for 24 hours following administration of OMNIPAQUE.

Unfortunately, until the packaging materials are more explicit, radiologist pay prefer to operate in CYA mode. If something did happen to the infant and a mother received contrast media, not sure radiologist would be legally covered if he advised mom to continue breastfeeding, even in light of ACR recommendations.

Alex Walker, BSN, RN, IBCLC

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