Botox, botulinum toxin from the bacteria Clostridium botulinum, is a substance that causes nerve paralysis. Botulism results from exposure to this bacterial toxin from contaminated food or in an open wound. Infants may develop botulism from contaminated food and infected dust particles. Twenty percent of infantile botulism cases come from ingesting raw honey. Symptoms of infantile botulism include weakness, poor feeding, droopiness of facial muscles and excess drooling due to a weak suck reflex.
Botox, the medicinal form of botulinum toxin, is used in various medical treatments such as wrinkles, neck spasms, headaches, and overactive bladder. Botox injections rank as the most popular minimally invasive cosmetic procedure, and among women receiving Botox in 2020, 19% were 20-39 years old. It is no wonder why we receive many questions about the safety of Botox during lactation.
This week’s article is the first study to measure transmission of Botox into breastmilk. The researchers studied breastmilk samples from 4 lactating women who underwent cosmetic injections with 40-92 units of Botox. Milk samples (60 ml) were collected at 2 hours and days 1, 3, 5 after treatment, for a total of 4 samples each.
They found that 8 of the 16 samples had varying levels of botulinum toxin ranging from 85.24 to 746.82 pg/ml, while 8 samples had no toxin detected. Based on an average intake of 670ml of breastmilk/day, a breastfed infant would ingest 0.499µg of Botox toxin in 24 hours. The lethal dose, based on primate studies, is considered 1µg/kg. For a 10 lb (4.5kg) infant the lethal dose would be 4.5µg. Therefore, the amount of Botox exposure in this study was much less than the lethal dose.
What else? See the question!
angela
It seems at this point there is not enough data to confidently say Botox is safe for breastfeeding mothers.
We do know Botox is passed into the breastmilk and for babies that are premature or under 10 pounds, Botox is a contraindication for breastfeeding mothers.
Audrey
The answers to the question is very ambiguous. We definitely need more research and study to support either safe or not safe to use Botox during Lactation. It would probably be wise to have our client evaluate the pros and cons of using Botox during breastfeeding. Hopefully, for the premature infant, those mother would be more concern about protecting their breast milk for her infant vs. taking care of wrinkles! But I do understand each circumstance needs to be treated individually.
Jennifer Scales
if 20% of cases of botulism is from direct exposure to honey, what is the source of the of the other 60%? Contaminated food and dust particles? Also, curious how prevalent botulism is among infants.
Jennifer Scales
meant to say 80% not 60 🙂
IABLE
YOu are correct, the rest of the botulism cases are due to contaminated food and dust particles. The rates of infantile botulism vary by state. Here is a CDC report on the incidence of infantile botulism in 2019 https://www.cdc.gov/botulism/surv/2019/index.html#:~:text=Infant%20botulism%20cases&text=Cases%20were%20reported%20from%2032,(1%2C%20%3C1%25).