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Subject:
From:
LuAnn Smith <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 26 Aug 2007 22:22:19 -0400
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Looking for collective wisdom and an approach

We have been battling CT scan at our hospital both technicians and 
radiologists. They instruct mothers to "pump and dump" for 25-48 hours 
following Omnipaque administration, depending on dosing. According to Hale, 
this is not needed, listing Omnipaque, even in intravenous form as an L2.  
The American College of Radiologists (ACR) suggested in a publication from 
the 90's that  this would most likely be cautiously used in breastfeeding 
mothers. .

We have had an e-mail discussion between radiology and neonatology and 
lactation and we thought there was a concensus  to share info with mother 
and allow her to make the informed choice to pump or not after sharing as 
specific info as we have. Sadly, we seem to agree to disagree and moms are 
left to decide what they are going to do.  The half life of this drug is 2 
hours and the transfer inot human milk is less than 0.5% - I don't have the 
specifics re: this in front of me, but did review it earlier today.

Again with the new focus on ethics, I hate to contradict and have encouraged 
patients involved to contact the baby's pediatrician for a final OK if they 
are receiving conflicting info.

Does anyone have any experience with any poor outcomes with this contrast 
agent and any specific info on any real hazards to the infant?  As a former 
NICU nurse, I've see  this agent be given to neonates for contrast as well, 
so what is the exact issue, other than "sacrificing breastfeeding on the 
altar of ignorance",  as I've heard Linda Smith say more that once!

Today we had a mom refuse her scan, because she was given this info, and 
then they adjusted their advice based on her extreme desire to keep nursing 
after a very difficult start while still  in the hospital. I was so proud of 
her for being empowered enough to speak up for her and her baby. So many 
other mothers would never do this... again, mothers should not have to fight 
so hard to breastfeed  babies!

LuAnn Smith RN, BSN, IBCLC

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