Botox is a trade and generic name for an injectable medication prepared from a purified neurotoxin called botulinum toxin type A. Some of the other names of the toxin include botulin A, botulinum A, and onabotulinumtoxinA.
The botulin toxin is produced by the bacteria Clostridium botulinum, also known as the botulinum bacteria (1). Small quantities of the toxin are often used in various medical and cosmetic procedures. However, before deciding to take it while breastfeeding, it is crucial to know if it has any adverse effects since many medicines may pass into breast milk.
Read this post for information about the safety of Botox while breastfeeding and the alternatives available.
What Are The Uses Of Botox?
- Chronic headaches, such as migraine
- Chronic or deep wrinkles
- Urinary incontinence
- Strabismus (crossed eyes)
- Cervical dystonia (involuntary contraction of neck muscles in abnormal positions)
- Upper limb spasticity (overactive arm and hand muscles)
- Severe axillary hyperhidrosis (excessive underarm sweating)
- Blepharospasm (involuntary blinking or twitching of eyes)
How Does Botox Work?
Botox injection causes temporary paralysis of muscles by blocking signals from nerves to the targeted muscle (3).
Our brain sends signals to the nerve cells to initiate a muscle contraction. In response, the nerve cells release a neurotransmitter called acetylcholine, which conveys the message to the targeted muscle, resulting in muscle contraction. Botox inhibits the release of acetylcholine, preventing the muscle from receiving the message. As a result, the muscle relaxes, ceasing any movements or contractions.
Since Botox relaxes muscles, it is often used in treating conditions that involve muscle spasms or abnormal or undesired muscle contraction (4).
Safety Of Botox While Breastfeeding
There is currently no research about the safety of Botox treatment during breastfeeding. In general, botulinum toxin A might find its way to breast milk through blood. However, it is likely when a person is experiencing botulism, a severe infection caused by the botulinum bacteria.
Since only a small amount of purified bacterial toxin is injected during the Botox procedure, the chances of the toxin entering mothers’ milk are slim. Still, due to the absence of any conclusive studies, it is best to avoid Botox injections while breastfeeding (5).
Doctors may avoid prescribing Botox treatment if you are breastfeeding, and the treatment may only be conducted in rare cases (6). In most cases, alternatives to Botox could be available. It is best to avoid Botox for cosmetic reasons when breastfeeding.
Side Effects For Breastfeeding Mothers
There is no information about the secretion of botulinum toxin type A in breast milk. Therefore, the side effects on the nursing infant are unknown.
- Bruising, redness at the site of the injection
- Dry mouth
- Skin rash
- Flu-like symptoms
- Difficulty in breathing, swallowing, or talking
- Problems with vision such as blurred vision, double vision, or drooping eyelids
- Loss or change of voice (voice may become raspy, hoarse, or weak)
- Muscle weakness
- Urinary incontinence (loss of bladder control)
- Slurred speech (an issue with clear pronunciation of words)
Can Pumping And Dumping Reduce The Effects Of Botox?
Pumping and dumping is a technique of expressing breast milk and discarding it instead of feeding it to the infant. Many mothers pump and dump breast milk if they believe they have ingested a substance that may pass into breast milk and reach the baby. However, pumping and dumping cannot eliminate the substance from breast milk. The substance will continue to be secreted in breast milk until entirely metabolized by the body.
The exact metabolism time for Botox in the body is unknown. Its effect may last for about 8-12 weeks (3). Also, the passing of Botox in breast milk has not been studied. Hence pumping and dumping method may not work in this case.
Guidelines For Preventing The Serious Effects Of Botox
Taking certain precautions may help prevent serious side effects of Botox. Here are a few things to keep in mind (2).
- If you are breastfeeding and need Botox for a medical condition, seek the advice of an experienced doctor who is an expert in your medical problem. Understand the benefits and risks to make the right decision.
- It is best to avoid the risk of getting Botox for cosmetic purposes if you are breastfeeding. Check with the doctor for alternatives.
- Inform your doctor about the other medications you take. Make sure to include prescription, non-prescription, multivitamins, or herbal medications.
- Tell your doctor if you have been taking allergy medicines, including for asthma, sleeping pills, muscle relaxants, cold medicines, antiplatelets, anticoagulants, or took an antibiotic injection recently.
- Let your doctor know if you have taken any form of botulinum toxin in the last four months. Share the details of your past Botox injections, too.
- If you have a history of allergies to any medicine or had an allergic reaction recently, do share it with the doctor.
- Your doctor should know if you plan to have any surgery or have had any surgeries in the past.
Safe Alternatives To Botox For Breastfeeding Moms
The alternatives to Botox could vary based on the problem, the intensity of the condition, and your overall health. Discuss the other options with your doctor.
Below are some alternatives that may be considered for a few conditions that are often treated with Botox injections.
- Acetaminophen (Tylenol), ibuprofen (Motrin), naproxen (Aleve), and sumatriptan (Imitrex) are a few lactation-safe medicines for migraine (8). Do take a prescription from a doctor to avoid overdose.
- Overactive hand and arm muscles and muscle spasms could be managed with physical therapy, occupational therapy, or regular massages (9).
- You may consider facial cosmetic acupuncture (FCA) instead of Botox to reduce wrinkles and improve skin elasticity. The method involves the insertion of acupuncture needles in the head, face, and neck (10).
- Topical, over-the-counter cosmetic products, such as creams, may also help reduce wrinkles and improve your skin tone.
- Eating a wholesome diet, sleeping for seven to nine hours at night, and drinking adequate water can also rejuvenate the skin.
Botox has several uses, with a rapid increase in its use for cosmetic procedures. The implications of its use during breastfeeding have not been extensively studied. Therefore, it is advisable to avoid Botox until you are done with the lactation phase. Consulting an experienced doctor can help you weigh the pros and cons if there are no alternatives to Botox for your treatment.
2. FDA.; Botox Label
3. Indian Journal of Dermatology; Botulinum Toxin NCBI
4. American Academy Of Facial Aesthetics; BOTOX Procedures: What is BOTOX & How Does it Work
5. LactMed Botulin A U.S. National Library of Medicine
6. Moorfield’s Eye Hospital; Botulinum toxin injections for strabismus (squint) during pregnancy and breastfeeding FAQ’s
7. Bakheit AM,; The possible adverse effects of intramuscular botulinum toxin injections and their management U.S. National Library of Medicine
8. American Migraine Foundation; Migraine Treatment and Breastfeeding
9. American Association of Neurological Surgeons; Spasticity
10. Hindawi;Effect of facial cosmetic acupuncture on facial elasticity: an open-label, single-arm pilot study NCBI