mother holding a baby, thinking about the safety of botox while breastfeeding
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Last Updated On: April 15, 2024

Should You Administer BOTOX® to Breastfeeding Patients?

Published on: Apr 15, 2024

The main dilemma in the discussion about BOTOX® and breastfeeding revolves around insufficient research. 

A 2024 pilot study has shed some light on the issue, but it only highlights the need for more comprehensive data collection. The intent of this blog post is to provide doctors with recent data to help them make proper choices during the patient’s consultation on BOTOX® while nursing.

Key Takeaways

  • Professional Guidance: This article serves to update healthcare providers with the latest findings on BOTOX® and breastfeeding, aiding them in offering evidence-based advice during patient consultations.
  • Safety Concerns: The primary concern for breastfeeding mothers considering BOTOX® is the potential transfer of the toxin to breast milk and its effects on the infant.
  • Pilot Study Insights: Early research indicates that while BOTOX® can be detected in breast milk, levels are typically lower than harmful thresholds, suggesting breastfeeding might not need to be discontinued post-treatment.
  • Consensus Needed: The absence of a clear consensus among experts about BOTOX®’s safety during lactation underscores the need for more research.
  • Considerations for Use: Decisions around BOTOX® during pregnancy should carefully weigh potential risks, with current data not definitively linking BOTOX® to miscarriage or birth defects but also not ruling them out.

Understanding BOTOX® and Its Use During Breastfeeding

The BOTOX® is one of the most popular cosmetic and medical procedures as it can be used to treat a wide range of indications, from facial wrinkles and BOTOX® lip flips, to muscle disorders, hair treatment, and more. Breastfeeding mothers might also consider getting BOTOX® to increase postpartum aesthetics or to solve medical problems that can be treated with this injectable. 

Among the safety concerns of administering botulinum toxins during lactation is that the substance may be transferred into the breast milk and thus affect the baby.

Analyzing the Research: BOTOX® Use During Breastfeeding

The latest investigations into the safety of BOTOX® while nursing, and a study published in 2024, give the medical community a chance to delve into the controversial topic. 

The study focused on the possible side effects of the use of facial botulinum toxin injections for breastfeeding women and whether botulinum toxin could be detected in breast milk after injections. 

The study was conducted on four lactating women selected according to strict criteria. The results showed that BTXA is detectable in some cases, but the levels of BTXA in breast milk were significantly lower than the dangerous levels for infants. It implies that the continuation of breastfeeding during BOTOX® or BOTOX® COSMETIC treatments will not necessarily be a reason for stopping breastfeeding, thus opposing the conventional precautionary approach.

For the time being, lactating mothers are being cautiously advised to use onabotulinumtoxinA. The general sentiment is that the suspected toxin’s ineffective bloodstream presence diminishes the risk of its transfer through breast milk. Hence, the adverse effects of BOTOX® for breastfeeding mothers are thought to be little. Nevertheless, healthcare providers highlight the necessity of consulting with a specialist if a woman intends to use BOTOX® injections while breastfeeding or during pregnancy.

The available research, including the studies on BOTOX® during pregnancy and breastfeeding, brings out the fact that there is no unanimity among experts on the drug’s safety. This gap highlights the necessity for further research to shed more light on the actual consequences of BOTOX® injections and nursing. At the present moment, mothers are advised to consider the benefits and risks of BOTOX® while pregnant or breastfeeding in consultation with their healthcare provider.

BOTOX® Considerations for Expectant and Nursing Mothers

As health care providers, it is imperative to comprehend the effects of providing onabotulinumtoxinA and also understand the patient’s motivations, especially when administering it to pregnant and lactating women. The safety question is one that worries many breastfeeding and pregnant women who want to get BOTOX® either for cosmetic or therapeutic reasons.

woman on consultations regarding botox treatment while breastfeeding

Would BOTOX® Be Safe During Breastfeeding?

BOTOX®’s safety when nursing is a topic with limited research. The main worry is that the toxin can be passed on to the child via breast milk. Given the molecule’s size and its mechanism of action, the theoretical risk to the breastfeeding infant is minimal, suggesting that getting BOTOX® while breastfeeding may not necessitate cessation of lactation.

BOTOX® during pregnancy and lactation

Likewise, in the case of BOTOX® use during pregnancy, the discourse is equally complex. Miscarriages, which is one of the common concerns of women during pregnancy, have not been definitively linked to BOTOX® because of its negligible absorption at the systemic level. Yet, the lack of extensive studies on BOTOX® injections during pregnancy would suggest the need for more caution, with the background risk of birth defects still in mind.

Potential Pregnancy-Related Risks

It is still unclear what effect BOTOX® injections during pregnancy have on certain pregnancy outcomes, for example, preterm birth or low birth weight. This research gap draws attention to the fact that caution must be exercised when contemplating BOTOX® injections when lactating or pregnant.

Long-Term Considerations

The long-term effects of BOTOX® exposure during pregnancy on child development, such as behavioral or learning problems, are yet to be investigated by medical science. Due to this scarcity of data, it is recommended that expectant and breastfeeding mothers should be treated with caution before choosing BOTOX® as a treatment option.

The available information does not provide enough evidence to prove that BOTOX® is harmful to mothers during pregnancy or lactation. However, complete research is a must before a case-by-case assessment can be done. 

Practitioners should give advice to pregnant or breastfeeding women regarding BOTOX® taking into account the current understanding of its pharmacokinetics and the individual risk profiles and always erring on the side of caution until more definitive studies are available.

FAQ

Can you get BOTOX® while breastfeeding?

Current evidence suggests minimal risk of BOTOX® transferring to breast milk due to its large molecular size and localized action. However, due to limited research, consulting with a healthcare professional is advisable before proceeding.

Is It Safe To Get BOTOX® While Breastfeeding?

While no direct studies conclusively prove the safety of BOTOX® during breastfeeding, theoretical risks are considered low. A healthcare provider can offer personalized advice based on individual circumstances.

How long after BOTOX® can I breastfeed?

Given BOTOX®’s localized effect and minimal systemic absorption, there’s no established waiting period before resuming breastfeeding. However, discussing any concerns with a healthcare provider is recommended.

How long after BOTOX® can you have a baby?

BOTOX® does not have a known impact on fertility or pregnancy onset. However, if planning a pregnancy, consider discussing your BOTOX® treatment timeline with a healthcare professional to align with best practices for pre-pregnancy health.

Can I do fillers while breastfeeding?

Dermal fillers are generally considered safe during breastfeeding due to their localized application and minimal systemic absorption. However, as with all cosmetic treatments, consulting with a healthcare provider beforehand is prudent.

Does BOTOX® enter the bloodstream?

BOTOX® acts locally at the injection site and is designed to have minimal systemic circulation. While trace amounts might enter the bloodstream, they are typically insufficient to cause systemic effects.

Can I get BOTOX® while pregnant?

Due to the lack of comprehensive research on the effects of BOTOX® during pregnancy, the conservative approach is to avoid BOTOX® treatments while pregnant. Discuss any treatment considerations with a healthcare provider for guidance tailored to your health profile.

References

Hudson C, Wilson P, Lieberman D, Mittelman H, Parikh S. Analysis of Breast Milk Samples in Lactating Women After Undergoing Botulinum Toxin Injections for Facial Rejuvenation: A Pilot Study. Facial Plast Surg Aesthet Med. 2023;10.1089/fpsam.2023.0326. doi:10.1089/fpsam.2023.0326.

Organization of Teratology Information Specialists. OnabotulinumtoxinA (BOTOX®). In: Mother To Baby Fact Sheets. Brentwood, TN: Organization of Teratology Information Specialists; 2022 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582605/

National Institute of Child Health and Human Development. Botulin A. In: Drugs and Lactation Database (LactMed®) [Internet]. Bethesda, MD: National Institute of Child Health and Human Development; 2006-. [Updated 2024 Feb 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501400/