Can you get Botox while breastfeeding?

What does the evidence say about Botox while breastfeeding?

1. Breast milk sampling after cosmetic Botox found no detectable levels in two women following 54 to 92 unit doses, while two other women had peak levels of 422 to 747 ng/L, and a more recent small study of three women found a highest observed concentration of just 33.4 ng/L four days after injection. 1
2. An international headache society guideline lists onabotulinumtoxinA as acceptable for breastfeeding patients who have chronic migraine, and the entry notes no special precautions are called for with cosmetic use specifically. 1
3. Because onabotulinumtoxinA does not appear to get into the bloodstream after an injection, limited research on cosmetic use during breastfeeding did not detect it in breast milk, and no side effects were reported in the breastfed children of mothers who received it. 2
4. In the one study that directly measured breast milk after cosmetic injections in 4 women (40 to 95 units total), onabotulinumtoxinA was detectable by ELISA in 2 of the women, 8 of 16 samples, at levels of 85.24 to 746.82 pg/mL, an amount the reviewing authors describe as below the reported lethal dose for an infant, while cautioning that confirming clinical studies are still lacking. 3
5. MotherToBaby's own consumer guidance is more cautious than the technical data alone might suggest: it notes that many providers suggest avoiding Botox during both pregnancy and lactation, and that pausing cosmetic injections may be worth it for anyone who wants to take the lowest-risk path while nursing. 4

How Botox changes by nursing stage

• Early weeks. Early postpartum. If you had standing Botox appointments before delivery, most providers ask you to hold off on new cosmetic injections until after your postpartum checkup, partly so any recovery needs get addressed first.
• Established nursing. This is when most of the limited breastfeeding data comes from, including small studies measuring Botox levels in milk after cosmetic injections. An international headache guideline lists it as acceptable for breastfeeding patients who have chronic migraine specifically.
• Weaning. Weaning or less frequent nursing. Less milk being produced means even less theoretical transfer, though the research base doesn't really change with your feeding frequency. Any decision still comes down to a conversation with your provider about your specific situation.