Can X-ray Affect Breastfeeding

Ava Flores
• Thursday, 03 December, 2020
• 7 min read

Are a form of electromagnetic radiation similar to light, but with a shorter wavelength. X-rays are present only during the time that the image is being taken and leave no radiation or radioactivity in the body or in milk.

breastfeeding painful
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You’re constantly worried about the safety of your baby while you’re pregnant, but the list of dos and don’ts doesn’t end once you’re postpartum, especially if you’re breastfeeding. As Pediatrician Natasha Burger noted on Babysitter X-ray radiation can kill off a few living cells in your breast milk, but your baby won’t be exposed to the rays.

Burger wrote that if you undergo an X-ray that requires the injection of radioactive isotopes, such as a marrow or bone scan, you may have to wait to resume breastfeeding. Your breast milk and nursing babe are also safe even if your X-ray includes contrast dyes to help with imaging or barium.

The Academy of American Pediatrics writes that when using dominated contrast or gadolinium, about 0.04 perfect of the intravenous dose reaches human milk. Of course, if you feel more comfortable holding off on non-urgent screenings till you’re done nursing that’s more than OK. Just know your dentist probably won’t buy the breastfeeding excuse when you try to get out of your yearly appointment.

(Source: www.thebump.com)

The data presented here is intended to provide some immediate information but cannot replace input from professionals. X-rays are used to look at bones and other structures within the body e.g. to identify fractures, to look at the state of teeth, to determine damage to joints, pneumonia etc.

A detector on the other side of the body picks up the X-rays after they’ve passed through and turns them into an image. Dense parts of your body that X-rays find it more difficult to pass through, such as bone, show up as clear white areas on the image.

Softer parts that X-rays can pass through more easily, such as your heart and lungs, show up as darker areas. Barium is an inert agent which shows up under the X-ray but is not absorbed into the body so would not affect the breastfed baby.

Dr Wendy Jones BE, Orchards and the Breastfeeding Network Sept 2019 It is also usually fine to be exposed to “contrast dye,” which is sometimes injected before an imaging scan to help illuminate certain parts of your anatomy.

Talk to the radiologist and your pediatrician about how long it will be necessary to feed your baby stored breast milk or formula. This article shares useful resources to discuss with your health professionals regarding the compatibility of various diagnostic tests while breastfeeding.

approach process chapter breastfeeding comprehensive introductory intechopen figure
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The Academy of Breastfeeding Medicine (ABM) Protocol #30 1 refers to guidelines from The American College of Radiology (ACR) 2 that say all breast imaging studies and biopsies are safe for breastfeeding women. Dr Jack Newman, a Canadian pediatrician and breastfeeding expert, states that it is not necessary to wean prior to diagnostic tests on the breast.

If there is urgency in making a diagnosis, waiting for the mother’s milk to dry up is not rational, since it may take several weeks. X-rays don’t affect breast milk and a mother can continue to breastfeed straight after the X-ray 3.

Occasionally a contrast agent is used with an X-ray to improve the image quality of the soft tissue e.g. barium may be used, either swallowed or as an enema. Ultrasound helps distinguish between fluid filled (cystic) and solid masses by high frequency sound waves used to see inside the breast.

MRI scans use strong magnetic fields and radio waves to produce clear pictures of the inside of the body. Excerpt from Although MRI is less sensitive in the setting of lactation due to increased parenchymal density and vascularity, it nevertheless is not contraindicated and may provide diagnostic and treatment planning benefit.

Excerpt from ACR Appropriateness Criteria® Breast Imaging of Pregnant and Lactating Women. 2018 although not the initial imaging tool of choice, screening breast MRI is not contraindicated during lactation and may be considered in lactating women with a high lifetime risk of breast cancer.

(Source: www.slideshare.net)

13 Manufacturers’ package inserts may say that breastfeeding is not recommended for 24 hours after use 14, however several authorities on the subject suggest this is not necessary: Salesmen online explains that Gadolinium has a short half-life (1.6 hours), is poorly absorbed orally by the mother and only reaches breast milk in incredibly low levels therefore 24 hours interruption of breastfeeding seems extreme.

2020 Recommendation Because of the very small percentage of gadolinium-based contrast medium that is excreted into the breast milk and absorbed by the infant’s gut, we believe that the available data suggest that it is safe for the mother and infant to continue breast-feeding after receiving such an agent. Wendy Jones, UK pharmacist and author, has reviewed the evidence and concludes MRI scans are compatible with breastfeeding with or without gadolinium, and she cites guidelines from The Royal Australian and New Zealand College of Radiologists (RAN ZCR) 15 16.

Core needle biopsy after a full image work-up is the preferred diagnostic procedure for a breast lump. A fistula tends to be a complication arising from a biopsy, abscess or surgical procedure on a lactating breast.

Excerpt from An important factor in preventing a fistula is to continue breastfeeding on that breast. If the mother doesn’t, the milk is likely to find the path of the least resistance to flow, which may be this relatively large opening .

If the mother does not want to stop breastfeeding on that side and can tolerate the leaking, there is no harm in leaving the fistula. In this situation using medication to reduce milk supply would affect both breasts so is best avoided.

(Source: www.onlymyhealth.com)

A CT scan uses a powerful X-ray and computer to create images from inside the body. As part of the procedure special dyes or “contrast agents” may be injected or swallowed to improve image visibility.

Excerpt from Dominated Contrast Media Guideline V2.3, The Royal Australian and New Zealand College of Radiologists (RAN ZCR), 2018 Cessation of breastfeeding or expression and discarding of breast milk after dominated contrast media administration are not required Breastfeeding and the Use of Contrast Dyes for Maternal Tests, Clinical Lactation, 2011, by Kay Hoover IBC LC.

Intravenous pyelogram (MVP) is another type of X-ray using a contrast medium that helps the radiologist check the health of the kidneys, ureters and the bladder. In Cancer and Breastfeeding (Breastfeeding Today, LL LI, 2015), Diana West, IBC LC answers the most commonly asked questions breastfeeding mothers have when faced with testing and treatment for cancer including; imaging techniques, needle aspiration, biopsy, radioactive isotopes, radiation therapy, chemotherapy and anesthesia.

Excerpt from Imaging techniques used for diagnosis of pathology (such as ultrasound, mammogram, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, 2-Methoxy Isobutyl Isonitrile (MINI) scan, electrical impedance tomography (EIT) scan, computed tomography (CT) scan/computer axial tomography (CAT) scan, thermographic, or diaphanography) are non-invasive and do not affect milk production or safety. It may be more difficult to interpret breast tissue results due to the increased density from lactation, but it is not impossible.

Breastfeeding during chemotherapy is absolutely contraindicated because the medications used to eradicate cancer are highly toxic and transfer into milk. Breastfeeding after chemotherapy has been completed may be possible, either by relactation or as a result of another pregnancy, depending upon the drugs that were used.

(Source: www.onlymyhealth.com)

Radioisotopes may require stopping breastfeeding for a short time to avoid exposing a baby to excess radioactive material. The period of interruption will depend on the type of radioactive substance used, and the dosage and age of your baby.

The mother will need to pump regularly during any interval to avoid mastitis or a drop in her milk supply. If a mother has sufficient expressed breast milk already stored prior to the test, this can be fed to her baby during this waiting period.

See below for information on whether the milk pumped during the break in breastfeeding can be used after a waiting time or whether it should be thrown away. Exposing a baby to this breast milk could affect their own thyroid gland function or future risk of thyroid cancer and increase the mother’s radiation exposure in the breast tissue.

26 Inside Radiology recommends interrupting breastfeeding for 24 hours after this type of scan: Whether 24 hours is required in all cases may depend on the radioisotope used during the test and the protocols in place at individual hospitals.

In Use of Radioisotopes (and Other Imaging Agents) During Lactation Kelly Sonata explains that as a general rule breast milk stored in the waiting period after a diagnostic test with a radioisotope can be used after five half lives have passed: Technetium 99M In Breastfeeding and Radioactivity, lactation online conference 2013, Veronica Area, Head of the Department of Safety and Environmental Impact (INVAR), stated that the preferred radioisotope for a breastfeeding mother is Technetium 99 metastable (Tc99m).

(Source: www.onlymyhealth.com)

HalesMeds.com discuss that although the radioactive half-life of Tc-99 m is fixed at six hours the time needed to stop breastfeeding or store breast milk may be less than 30 hours (five half lives) as it will depend on which formulation of Tc-99 m is used and recommendations can also vary between advisory bodies. Interrupt breastfeeding as directed by the medical team to give time for the radioactivity to reduce to an acceptable level.

28 Minimize close contact with children after the procedure for the same specified period of time as in #1 above, keeping a distance of 2-3 meters between parent and child where possible (Cain, 2018) taking account of the children’s emotional needs: X-rays, MRIs, CT scans, Intravenous Pyelogram (MVP), ultrasound and mammograms do not affect breast milk.

Radioisotopes however, may require interrupting breastfeeding for a short time to avoid exposing a baby to excess radioactive material.

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