Today it is difficult to find a person who is not aware of the dangers of ionizing radiation. However, despite the entire volume of available information, it is necessary to resort to diagnostic procedures performed using x-rays quite regularly. It would seem that what could be simpler than conducting a routine fluorographic examination or x-ray according to indications?
Such an indifferent attitude is typical for the average person, but is absolutely not typical for a pregnant or lactating woman, for whom the health of the child comes first. It is known that even minor exposure to radiation in the early stages of pregnancy can cause disruption in the development of the fetus, as well as unpredictable long-term consequences in the later stages. But what effect can radiation have on the body of a nursing mother, and is x-raying really harmful to the baby during breastfeeding? The answer to this and other questions can be found in the article.
The mechanism of the effect of ionizing radiation on the body
In order to track the relationship between the effect of x-rays on the mother’s body and the likelihood of a risk of negative impact on the child during breastfeeding (BF), it is necessary to obtain a minimal understanding of the ionization mechanism. Radiation, which is a stream of energy used to obtain x-rays and has the ability to pass through various obstacles, including the human body.
Due to the fact that the density of tissues and the location of internal organs create a heterogeneous barrier to radiation, overcoming obstacles leads to a partial loss of its intensity, which makes it possible to obtain an overexposed image in accordance with the anatomical features of the part of the body being examined. Thus, the rays that leave the body react with photographic paper, and the remaining rays react with the cells of the body.
The electrical interaction of radiation with the atoms of cells leads to irreversible damage, and the factor determining the amount of damage caused is the duration of exposure. The ability of radiation to split hydrogen atoms, which are in excess in the body in the form of water, leads to the formation of free radicals, which, in turn, cause a chemical reaction that disrupts the functional activity of surrounding cells at the molecular level.
Important! Due to the fact that the irradiation time at the time of taking an x-ray is several seconds, the damage caused to the body is minimal and is quickly eliminated by triggering the regeneration mechanism.
The effect of x-rays on the ability of lactation
Thus, the fact of the negative impact of X-rays on the body of a nursing mother is undeniable, but is ionizing radiation capable of directly affecting the reproduction of breast milk? Taking into account that the radiation dose received during X-ray diagnostics is so insignificant that it is unable to cause any serious damage to the tissues, thus depriving them of the ability to produce milk, the danger may lie in the milk itself, which is in the breast at the time of the procedure. picture.
Naturally, in this case we are not talking about an x-ray of an arm, leg or tooth, since the beam of rays used to take x-rays is quite narrow and is unable to have any effect on the body as a whole, and especially on the chest area. From this point of view, the following studies can be considered the most dangerous:
- mammography;
- fluorography;
- chest x-ray.
Important! The minimum threshold of radiation that can cause serious damage to the body is 1.5 3V (sievert), and the total number of diagnostic procedures performed using X-ray equipment is only 1.4 m3V (milisivet) per year.
It is permissible to take an X-ray of a tooth even during pregnancy, since it uses a very narrow beam of radiation.
Pros and cons of the method
Using fluorography, serious diseases such as cancer and tuberculosis are detected. In the early stages they are practically asymptomatic. The more advanced the disease, the more difficult the treatment and the greater the impact on the body.
In addition to the importance of diagnosing dangerous diseases, fluorography and x-ray of the lungs have the following advantages:
- the ability to choose a gentle digital examination method;
- relative safety;
- painlessness;
- efficiency;
- rapidity.
The disadvantages include receiving a small dose of radiation. Having assessed the possible risk of untimely diagnosis, it becomes clear that fluorography is the lesser evil and does not have a negative impact on breastfeeding. The method has relative contraindications:
- age up to 15 years;
- period of bearing a child.
Is there any harm
Most doctors say that X-rays are not dangerous for breastfeeding. The effect of irradiation does not change the composition of mother's milk and does not affect the baby. Sometimes pediatricians advise putting the baby to the breast before the procedure, and after it, expressing the first milk. This recommendation is more aimed at reassuring mothers.
The radiation dose during fluorography is minimal. It is not harmful to human health and does not affect the quality of breast milk during feeding. For X-rays to become harmful to your health, you need to be exposed to them more than 100 times in a year. Significantly greater harm to breast milk from fluorography will be caused by excessive excitement and nervousness of the woman. If you can’t calm down, you can postpone the examination and do it immediately after stopping breastfeeding.
The effect of x-rays on the composition of breast milk
Another factor that elevates the effects of radiation to the rank of extremely dangerous phenomena is the ability to convert ordinary substances into radioactive ones. The essence of this process is the disruption of the stability of the nuclei of a non-radioactive substance due to prolonged exposure to ionizing radiation. As a result of such exposure, after the cessation of irradiation, the exposed substance continues to emit radiation for some time. In this case, the duration of radiation directly depends on the physical properties of substances.
There are three main options for the behavior of a substance exposed to radiation:
- death (for example, of a living cell);
- loss of stability (beginning of long-term or short-term radiation);
- modification (a substance changes its structure, but retains physical stability, that is, does not emit).
As you know, during breastfeeding the baby receives all the substances necessary for its full development. In addition to water, fats, proteins and carbohydrates, milk contains a complex of B vitamins, vitamins C, E and K, as well as a group of minerals:
- calcium Ca – 32 mg/100ml;
- potassium K – 51 mg/100ml;
- iron Fe – 0.03 mg/100 ml;
- magnesium Mg – 3 mg/100 ml;
- phosphorus P – 14 mg/100 ml;
- sodium Na – 17 mg/100 ml;
- zinc Zn – 0.17 mg/100 ml.
Important! Despite the fact that exposure to X-rays is extremely short-lived, the possibility of interaction of water, vitamins or minerals produced during lactation with ionizing radiation cannot be ruled out.
There is a possibility that X-ray radiation can affect the composition of breast milk. Unfortunately, there is no scientifically proven work on the changes that occur in breast milk after an x-ray, but the possibility of a physical reaction cannot be ruled out.
The least evil in this case will be the loss of useful qualities (in case of changes in physical properties), and the greatest will be the negative impact due to the acquisition of radioactive properties (loss of stability). It should also be taken into account that during feeding with milk exposed to x-ray radiation, even a short-term and mild negative effect will occur inside the child’s body, which will undoubtedly increase the harmful effects.
Legal standards
Contrary to the existing likelihood of a negative impact of radiological research methods carried out during breastfeeding on the child’s health, the Ministry of Health of the RSFSR, in its recommendations dated 02/06/2004 No. 11-2/4-09, is silent about the need to limit diagnostics for preventive purposes.
Harm from X-rays
In the orders issued earlier (Order of the Ministry of Health of the USSR dated March 29, 1990 No. 129 and Order of the Ministry of Health of the RSFSR dated August 2, 1991 No. 132), examinations carried out using X-ray equipment in women during lactation are permissible only according to strict medical indications.
The loyal attitude of the Ministry of Health to performing x-rays during breastfeeding is also demonstrated by the regulations “On the environment of a newborn,” which sets out the rules obliging a woman to undergo fluorography for the purpose of prevention, immediately after the birth of a child.
This attitude of the state is understandable from the point of view of setting priorities, where the probable risk of harmful effects of X-ray radiation on a nursing woman is offset by the real risk of tuberculosis. The decisive factor determining the need for preventive examination is the increase in reported cases of tuberculosis.
Important! Nursing mothers who are at risk must undergo a fluorographic examination without fail.
For a woman from a socially prosperous background, sometimes it is enough to provide fluorographic images of all her closest relatives
How to properly prepare for the procedure
The main rule when undergoing the procedure as a young mother is not to worry. The danger from X-rays is greatly exaggerated, in contrast to the serious consequences of an undetected disease and subsequent intensive antibiotic therapy, especially since the list of medications approved for use during lactation is limited. X-ray anxiety is more likely to affect breast milk. Due to stress, its production may even temporarily stop. The baby feels the mother’s condition, which affects his well-being. The baby may become fussy and have difficulty eating and sleeping.
If a young mother is undergoing fluorography and wants to maintain breastfeeding, the following precautions when preparing for the examination will help:
- attach the baby to the breast before undergoing the procedure;
- wear a lead apron for nursing women during the examination;
- prefer digital diagnostics;
- Remember to avoid X-ray exposure if it causes excessive anxiety.
These tips will help you calm down. Their implementation will maximally protect mother and baby during diagnostics.
Diagnostics with contrast
X-ray with contrast is another diagnostic method, the main purpose of which is to obtain detailed information about the condition of internal organs or the vascular system. Iodine-containing preparations are used as a contrast agent, which often cause a severe allergic reaction.
This diagnostic method is used exclusively according to indications, as a rule, in order to clarify the diagnosis. Taking into account that contrast is used mainly in computed tomography, in addition to radiation exposure, which is several times greater than conventional radiography, there is a risk of iodine-containing drugs passing into breast milk.
As a rule, x-rays are performed if the following pathologies are suspected:
- the presence of tumors in the chest or lungs;
- inflammatory lung diseases (pneumonia);
- tuberculosis.
Despite the fact that drugs in this group are characterized by a short half-life and fairly rapid elimination from the body, the possibility of penetration into breast milk cannot be completely excluded. Barium, used to obtain contrast images of the stomach, is not absorbed in the gastrointestinal tract, and therefore is not able to pass into breast milk. The use of radiocontrast agents makes it possible to detail information obtained using conventional x-rays.
Alternative diagnostic methods
The danger of exposure to ionizing radiation, even small doses, should not be underestimated. But what to do if diagnostics are still necessary? In such cases, the question of whether it is possible to take an x-ray during breastfeeding is not entirely correct, since a diagnosis not specified in time can pose a serious threat to health. In some cases, you can use alternative diagnostic methods that do not pose any danger (ultrasound, MRI).
Moreover, if ultrasound cannot provide the necessary amount of information, then the only limitation to MRI is its cost. Another way to take an x-ray while breastfeeding and avoid possible negative consequences for the baby is to wean him off the breast during the diagnosis. To do this, immediately before the procedure, he should be fed, and subsequently fed with pre-expressed milk or formula. Within 12–24 hours, milk should be expressed and poured out, and after the specified time period has passed, you can return to your usual method of feeding.
After X-ray diagnostics, it is recommended to express milk for 24 hours
The modern approach to the use of diagnostic studies suggests neglecting the likely risk of negative consequences after an X-ray during hepatitis B, considering it very insignificant. If the decision on the advisability of diagnostics is made by the doctor, then only the mother has the right to decide whether the child can breastfeed immediately after the procedure.
Alternative diagnostic methods that are safe during and after breastfeeding
If a woman refuses to undergo examination due to uncertainty that fluorography is safe during or after breastfeeding, they resort to alternative methods for detecting tuberculosis and other hidden pathologies:
- general, biochemical blood test;
- culture of sputum;
- listening with a phonendoscope;
- urine test - general and for the presence of microplasma;
- tapping the chest;
- throat swab;
- Ultrasound of the heart and lungs.
Possible harm from fluorography can be reduced by undergoing a digital examination. Unlike traditional film, radiation exposure during this procedure is 4-5 times less.
