Is It Possible to Get Breast Milk Tested for Trace Amounts of Botox?

We do not perform aesthetic service on pregnant moms to be or breastfeeding mom.  End of story.  There is not enough research to know definitively if the practice is safe.  There is no pressing health issue making it necessary to do the services.  It only makes sense to wait.  Now you are in the situation where you have had the service.  What should you do?  I do not believe that there is any evidence that this treatment will cause harm to your baby.  If you are uncomfortable, I suggest speaking with your pediatrician.  The safest course would be to immediately stop breastfeeding.  Should you do this?  This is a personal decision with very little evidence other than the knowledge that the dose you were given is very small and most likely primarily absorbed in the muscle tissue it was injected into.  Don't go back to this dermatologist.  This person lacks a moral compass.  

Hi Mom.  Sorry to hear about your situation.  We do not believe that your physician should have suggested this to you and would seriously consider searching out another practice.  Anyone that is going to suggest a breastfeeding mother have Botox injected is not scrupulous.  

With that said, there is no evidence to show Botox will or will not have an effect on your baby.  The reason credible practices will not offer it is that we just don't know and it's a silly risk to take.  The Botox should not affect your breast milk, but we doubt that any test you could find would give you the answer you are looking for.  We think it best to leave the issue alone and avoid any future injections while breastfeeding.

Because there haven't been any studies done on Botox and breastfeeding, the manufacturer of the drug Allergan Pharmaceuticals, recommends that Botox be used with caution in breastfeeding women. The effects Botox may have on an infant are unclear, but it is unlikely to pass through breast milk in amounts significant enough to cause problems since only a very small amount of it is injected into the targetted muscles or the face and the majority of that is taken up by the targetted muscles withing 2-4 hours of ingection and only an infintesimal amount of the drug reaches the bloodstream (which it must do in order to pass through breast milk).  You also stated that you were not making much milk and are likely bottle feeding your child and describe absolutely no signs or symptoms in your child suggestive of Botulinum toxicity. Although generally I do not suggest Botox or Dysport in immediate post-partum women who are breastfeeding, I do not see an appreciable risk in this situation. If you were being treated for torticollis or getting frequent injections of 200-300 units of Botox, then there is risk of some residual neuromodulator making it to the bloodstream and a small protion of that making it into the mild and that is still a theoretical risk. Given the amount with which you were likely treated, I see no real risk to the infant. Also, most make up including lipstick are used everyday by pregnant and breastfeeding women. Most of these cosmetics contain numerous preservatives and heavy metals as well as other dangerous toxins which are internalized through the skin and ingested everytime the individual licks their lips. There appears to be no concern about these cosmetics even though it clearly states on the lable that they are not for internal use or for children. After billions of doses of Botox injection around the world, there is no clinical evidence that would support any concern in this situation.

It is one thing to inadvertently inject Botox/Dysport/Xeomin into a woman who is pregnant or breast-feeding.  The manufacturers of these drugs suggest avoidance, and the medical literature is unclear of the risks.  However, it is quite another matter to inject these neuromodulators into a woman, fully aware that she is pregnant or breast-feeding, and on top of that dismiss any concerns.  I am absolutely horrified a colleague would knowingly do this.  I would feel morally obligated to discuss this with him/her for the sake of protecting the community and his other patients.  If he/she refused to stop I would make the Department of Health aware of this practice, for certainly it is not the community standard.

That being said, your baby will probably be safe.  Discuss this with your pediatrician, and if there is any concern stop breast-feeding.

Yoash R. Enzer, MD

We strictly avoid Botox, fillers, lasers, IPL treatments on pregnant or breast feeding women.

There are no studies proving that these procedures are safe or unsafe, but since they are elective  cosmetic procedures, they can and should be delayed till after pregnancy or breastfeeding.

Haowever, there are cases where a woman may get pregnant within days or  weeks of having received a filler or Botox or a Laser treastment

Again, no publications reporting harm from  any of the above to the mother or fetus. This should be partially reassuring to you.

Still, prudence dictates  no such treatments should be given to pregnant or  breast feeding women.