Botox and Breastfeeding: Treatment, Usage, & Safety

Botulinum toxin is a neurotoxin that disrupts the chemical signals between muscles and the brain upon injection. Botox is injected into the muscle of the area affected by the issue being treated. Once the neurotoxin takes effect, which typically takes a few weeks, the muscle that was injected will be temporarily paralyzed. Botox is able to block the transmission of neurosignals between the muscle and the brain, so the muscle does not receive the message to contract. The effects provided by Botox are temporary, typically lasting around four to six months, though the duration of results depends on a number of factors, including the age of the patient and the issue being treated. Patients should not receive Botox injections or any other botulinum toxin product more often than once every three months. At this time, there have not been many studies regarding the risks of using Botox while breastfeeding is not typically recommended.  

When is Botox used?

Botox is used to help treat or correct a number of issues related to muscle spasticity or muscle contractions. The injectable medication was first available in the late 1980s to help treat blepharospasm (involuntary closing and twitching of eyelid) and strabismus (crossed eyes). Since its first introduction to the market, Botox has been found to help treat a number of conditions both cosmetic and medical, some of which were discovered as a side effect of initial treatment for another issue. Researchers and physicians continue to find new uses for Botox and it is currently undergoing trials or research for a number of issues, including balding, erectile dysfunction, depression, and premature ejaculation. There are also a number of accepted off-label uses of Botox, including for treatment of vaginismus (painful sex in women) and the correction of cleft lip scars in babies.
Botox is indicated for the treatment of:

  • Overactive bladder syndrome, including incontinence;
  • Chronic migraines and headaches (for patients who experience headaches lasting four hours or more on 15 or more days during a month-long period);
  • Muscle stiffness in elbows, fingers, thumbs, ankles, or toes;
  • Cervical dystonia, including neck pain and abnormal head position;
  • Primary hyperhidrosis, including excessive sweating of the underarms, hands, feet, head, and face
  • Moderate to severe glabellar lines (lines that appear between the eyebrows);
  • Moderate to severe crow’s feet (lines that appear at the corners of the eyes);
  • Moderate to severe forehead lines.

As some of these conditions are medically debilitating, some doctors will still treat breastfeeding patients with Botox.

Is Botox safe while breastfeeding?

Botox is a recognized, safe medication for a number of medical and cosmetic issues and symptoms. However, the safety of Botox in pregnant or breastfeeding patients has not been the subject of much study, and therefore the manufacturer, Allergan, recommends that Botox should not be used on patients who are pregnant or breastfeeding. There have been no known reports of Botox being transferred from mother to child. Though Botox is safe when administered by trained healthcare practitioners, it can be dangerous and even deadly when administered improperly or if people are exposed to botulinum toxins in a non-medical capacity. Because of the possible dangerous effects associated with botulinum toxin, some physicians may be hesitant to administer Botox to patients who are breastfeeding. However, the American Academy of Pediatrics, New Jersey Chapter, believes that the amount of Botox used in cosmetic procedures is unlikely to affect breastmilk. It is also worth noting that once Botox is injected into the body, it remains in the local tissue for months, so expressing milk and dumping it and then resuming breastfeeding after in the hopes that the drug will have been metabolized would not be effective. However, it is also unlikely that the Botox would migrate from the muscle that it was injected into and move into the breast or milk glands. It is best that patient discuss the possible risks of Botox while breastfeeding with their doctor prior to any injections being administered.

Conclusion

As there is no clear research that indicates whether or not it is safe to inject Botox into a patient who is breastfeeding, most physicians and the manufacturer do not recommend using Botox during breastfeeding. However, if the use of Botox is necessary, it is best to speak with a physician about the risks associated with Botox or about alternatives to Botox.