Is Vitamin B6 compatible with breastfeeding? Do we have alternatives for Vitamin B6?

Vitamin B6

February 26, 2018 (Low Risk)

Daily allowance of vitamin B6 ranges from 2 to 3 mg (Ares 2015, Hall 2010, Chang 2002, Bender 1989). A balanced and varied diet is enough without a need for extra supplementation with this vitamin. Vitamin B6 deficiency is extremely rare since it is widely distributed in many foods.

In those cases where supplementation is required, it is recommended not to exceed 40 mg a-day (Hale 2017 p.817, Ares 2015).
Excessive doses (> 50-100 mg/day) and long-term administration (> 3 months) can cause neurological problems (ADRAC 2008, Bender 1989, Waterston 1987, Dalton 1987, Schaumburg 1983).

Concentration of vitamin B6 in the breast milk is directly related to the amount present in diet (Ooylan 2002) with the possibility of a high increment by an excessive consumption through the diet.
Concentration of vitamin B6 is higher in mature milk than in transition milk and in colostrum (Ren 2015)

There are controversial data on the capacity of a high dose of Pyridoxine to inhibit the secretion of Prolactin and suppress the milk production.

The American Academy of Pediatrics rates it as usually compatible with breastfeeding.
Eleventh WHO Model List of Essential Drugs: Compatible with breastfeeding at nutritional dose (WHO / UNICEF 2002).

Alternatives

We do not have alternatives for Vitamin B6.

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.

Synonyms

  • Adermine
  • Codecarboxylase
  • Metadoxine
  • Pyridoxal Phosphate
  • Pyridoxamine Hydrochloride
  • Pyridoxine Hydrochloride
  • Pyridoxine Pidolate
  • Пиридоксина Гидрохлорид
  • ピリドキシン塩酸塩

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. Ren X, Yang Z, Shao B, Yin SA, Yang X. B-Vitamin Levels in Human Milk among Different Lactation Stages and Areas in China. PLoS One. 2015Abstract Full text (link to original source) Full text (in our servers)
  3. Ares Segura S, Arena Ansótegui J, Díaz-Gómez NM; en representación del Comité de Lactancia Materna de la Asociación Española de Pediatría. La importancia de la nutrición materna durante la lactancia, ¿necesitan las madres lactantes suplementos nutricionales? [The importance of maternal nutrition during breastfeeding: Do breastfeeding mothers need nutritional supplements?] An Pediatr (Barc). 2015Abstract Full text (link to original source) Full text (in our servers)
  4. Hampel D, Allen LH. Analyzing B-Vitamins in Human Milk: Methodological Approaches. Crit Rev Food Sci Nutr. 2015Abstract
  5. Oladapo OT, Fawole B. Treatments for suppression of lactation. Cochrane Database Syst Rev. 2012Abstract
  6. Hall Moran V, Lowe N, Crossland N, Berti C, Cetin I, Hermoso M, Koletzko B, Dykes F. Nutritional requirements during lactation. Towards European alignment of reference values: the EURRECA network. Matern Child Nutr. 2010Abstract Full text (link to original source) Full text (in our servers)
  7. ADRAC. Adverse Drug Reactions Advisory Committee. High-dose vitamin B6 may cause peripheral neuropathy. Aust Adverse Drug React Bull 2008; 27: 14–15. 2008 Full text (link to original source) Full text (in our servers)
  8. Ooylan LM, Hart S, Porter KB, Driskell JA. Vitamin B-6 content of breast milk and neonatal behavioral functioning. J Am Diet Assoc. 2002Abstract
  9. Chang SJ, Kirksey A. Vitamin B6 status of breast-fed infants in relation to pyridoxine HCl supplementation of mothers. J Nutr Sci Vitaminol (Tokyo). 2002Abstract
  10. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  11. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  12. Gupta T, Sharma R. An antilactogenic effect of pyridoxine. J Indian Med Assoc. 1990Abstract
  13. Chang SJ, Kirksey A. Pyridoxine supplementation of lactating mothers: relation to maternal nutrition status and vitamin B-6 concentrations in milk. Am J Clin Nutr. 1990Abstract
  14. Bender DA. Vitamin B6 requirements and recommendations. Eur J Clin Nutr. 1989Abstract
  15. Waterston JA, Gilligan BS. Pyridoxine neuropathy. Med J Aust. 1987Abstract
  16. Dalton K, Dalton MJ. Characteristics of pyridoxine overdose neuropathy syndrome. Acta Neurol Scand. 1987Abstract
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  18. Schaumburg H, Kaplan J, Windebank A, Vick N, Rasmus S, Pleasure D, Brown MJ. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med. 1983Abstract
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  20. Vecchione A, Baccolo M. [Our experience in the inhibition of lactation (Controlled clinical study with bromocriptine, methergoline and pyridoxine)]. Riv Ital Ginecol. 1980Abstract
  21. Thomas MR, Sneed SM, Wei C, Nail PA, Wilson M, Sprinkle EE 3rd. The effects of vitamin C, vitamin B6, vitamin B12, folic acid, riboflavin, and thiamin on the breast milk and maternal status of well-nourished women at 6 months postpartum. Am J Clin Nutr. 1980Abstract
  22. Greentree LB. Inhibition of prolactin by pyridoxine. Am J Obstet Gynecol. 1979Abstract
  23. Greentree LB. Dangers of vitamin B6 in nursing mothers. N Engl J Med. 1979Abstract
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  25. de Waal JM, Steyn AF, Harms JH, Slabber CF, Pannall PR. Failure of pyridoxine to suppress raised serum prolactin levels. S Afr Med J. 1978Abstract
  26. McIntosh EN. Treatment of women with the galactorrhea-amenorrhea syndrome with pyridoxine (vitamin B6). J Clin Endocrinol Metab. 1976Abstract
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