Is Botulinum Toxin compatible with breastfeeding? Do we have alternatives for Botulinum Toxin?

Botulinum Toxin

November 24, 2014 (Low Risk)

Botulism is a severe disease caused by bacteria called Clostridium botulinum. The bacterium produces a paralyzing toxin which is used for treatment of muscle spasticity and other disorders.

Reportedly, a woman affected of severe Botulinum disease nursed her 8 months old son during illness. Neither bacteria nor toxin were detected in both mother’s milk and stools of the infant, who did not show symptoms of disease. Also, anti-toxin medication given to the mother did not produce side-effects on the child.

A high molecular weight along with a strong and rapid adherence to muscle plaque by toxin could explain its low excretion into breast milk.

When adequately and locally administered, serum levels of toxin should be low.

An infant born at 36 weeks of gestation, who had received intra-esophagus treatment with Botulinum toxin for achalasia during the last weeks of pregnancy, appeared healthy and did not show symptoms of hypotonia.

Mother’s milk shows neutralizing capacity against Botulinum Toxin. It has been shown that the secretory IgA is able to bind the B fraction of toxin, resulting in inhibition of toxin attachment to intestinal cells and hence impairing absorption. It would explain that severity of disease is lower among breastfed infants than bottle-fed ones, with no death cases reported and delay in appearance of symptoms among breastfed infants in cases of Infant Botulism type B.


We do not have alternatives for Botulinum Toxin.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.


  • Botulinum A Toxin
  • Botulinum B Toxin
  • Botulism
  • Clostridium botulinum
  • Αλλαντική τοξίνη
  • 型ボツリヌス毒素A
  • 型ボツリヌス毒素B


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