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).
We do not have alternatives for Vitamin B6.
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
- Pyridoxal Phosphate
- Pyridoxamine Hydrochloride
- Pyridoxine Hydrochloride
- Pyridoxine Pidolate
- Пиридоксина Гидрохлорид
Drug trade names
- Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
- 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)
- 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)
- Hampel D, Allen LH. Analyzing B-Vitamins in Human Milk: Methodological Approaches. Crit Rev Food Sci Nutr. 2015Abstract
- Oladapo OT, Fawole B. Treatments for suppression of lactation. Cochrane Database Syst Rev. 2012Abstract
- 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)
- 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)
- Ooylan LM, Hart S, Porter KB, Driskell JA. Vitamin B-6 content of breast milk and neonatal behavioral functioning. J Am Diet Assoc. 2002Abstract
- 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
- 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)
- 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)
- Gupta T, Sharma R. An antilactogenic effect of pyridoxine. J Indian Med Assoc. 1990Abstract
- 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
- Bender DA. Vitamin B6 requirements and recommendations. Eur J Clin Nutr. 1989Abstract
- Waterston JA, Gilligan BS. Pyridoxine neuropathy. Med J Aust. 1987Abstract
- Dalton K, Dalton MJ. Characteristics of pyridoxine overdose neuropathy syndrome. Acta Neurol Scand. 1987Abstract
- Andon MB, Howard MP, Moser PB, Reynolds RD. Nutritionally relevant supplementation of vitamin B6 in lactating women: effect on plasma prolactin. Pediatrics. 1985Abstract
- 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
- Scaglione D, Vecchione A. Pyridoxine for the suppression of lactation--a clinical trial on 1592 cases. Acta Vitaminol Enzymol. 1982Abstract
- Vecchione A, Baccolo M. [Our experience in the inhibition of lactation (Controlled clinical study with bromocriptine, methergoline and pyridoxine)]. Riv Ital Ginecol. 1980Abstract
- 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
- Greentree LB. Inhibition of prolactin by pyridoxine. Am J Obstet Gynecol. 1979Abstract
- Greentree LB. Dangers of vitamin B6 in nursing mothers. N Engl J Med. 1979Abstract
- Lehtovirta P, Ranta T, Seppälä M. Pyridoxine treatment of galactorrhoea-amenorrhoea syndromes. Acta Endocrinol (Copenh). 1978Abstract
- 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
- McIntosh EN. Treatment of women with the galactorrhea-amenorrhea syndrome with pyridoxine (vitamin B6). J Clin Endocrinol Metab. 1976Abstract
- Canales ES, Soria J, Zárate A, Mason M, Molina M. The influence of pyridoxine on prolactin secretion and milk production in women. Br J Obstet Gynaecol. 1976Abstract
- Macdonald HN, Collins YD, Tobin MJ, Wijayarathne DN. The failure of pyridoxine in suppression of puerperal lactation. Br J Obstet Gynaecol. 1976Abstract
- Marcus RG. Suppression of lactation with high doses of pyridoxine. S Afr Med J. 1975Abstract
- Foukas MD. An antilactogenic effect of pyridoxine. J Obstet Gynaecol Br Commonw. 1973Abstract