Should I use Botox while pregnant?
The answer is a clear, NO.
Using Botox while pregnant may cause fetal harm or loss.
Botulinum works by blocking signals between your nerves and your muscles. This is done by inhibiting the release of acetylcholine, which is the neurotransmitter responsible for telling the muscles to contract. When movement is restored to the face, it is because the body went through a regenerative process to sprout new nerve terminals and synapses once again capable of releasing acetylcholine.
Acetylcholine is crucial and abundant in many body processes. Your nerves use choline as a precursor to make acetylcholine. This allows the nerves to communicate. Using botulinum means, less working nerve terminals and synapses available to make this conversion.
Choline is essential to a developing fetus. It is crucial for the developing brain, but also plays an important roll in cell division, growth, and tissue expansion. It also plays an important role in maternal hormones, specifically hormones that regulate healthy growth of the fetus.
Choline is also crucial for normal body processes and brain function. Adults deprived of this nutrient show signs of organ dysfunction, and neurological disorders such as dementia, or Alzheimer’s disease. It has been shown to be a troublesome nutrient for postmenopausal women, as their choline needs are much greater. Further, it plays a significant role in hormone regulation, specifically estrogen. There are many members in our support group who have experienced a sudden onset of menopause after using botulinum. To learn more, please join HERE.
Information and studies have come a long way on the importance of choline. For this reason, prenatal vitamins contain necessary amounts to support the developing fetus. It is recommended that adults monitor choline in their diets to be sure that they receive enough and introduce a supplement to counteract any dietary deficits.
Lastly, botulinum drugs are listed as category C drugs. This means that there are no well controlled safety studies in humans. Safety studies based on human trials are not established, because of obvious ethical and legal concerns. Any use of botulinum during pregnancy is considered “off label,” and not approved by the FDA. The drug should only be used if the potential benefit outweighs the risk to the fetus. Several studies have shown that using botulinum “unknowingly,” during pregnancy has been associated with fetal defects, harm, or loss. Animal studies have also shown adverse effects to the fetus.
Sources listed below.
Links regarding botulinum use during pregnancy.
Choline is crucial for fetal development, it is critical for brain development, and other physiological processes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2441939/ (General info. on choline & fetal development)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466850/ (Prenatal choline may reduce risk of infant psychiatric illness)
https://www.bbrfoundation.org/.../higher-maternal-choline... (Role in brain development)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2954445/ (Dietary choline for women)
Botulinum drugs are listed as category C drugs.
“Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans..”
Animal studies
“Studies in mice, rats, rabbits have shown reductions in fetal body weights, delayed ossification, abortions, and/or fetal malformations.”
Botox Prescribing Information. Allergan Inc; 2004. [Google Scholar]
Safety & efficacy studies of botulinum use during pregnancy are not established because of ethical and legal concerns.
Botulinum use during pregnancy is considered off label use and not approved by the FDA meaning the drug is “administered during pregnancy only if the potential benefit justifies the potential risk to the fetus”
Botulinum use during pregnancy has been associated with fetal defects, harm, and loss.
For patient safety, some insurance companies do not cover botulinum use during pregnancy.
Should Botox be used during lactation?
The answer is a clear, NO.
You should not use Botox while lactating.
Due to ethical concerns, there are no studies done to establish the safety of Botox while lactating. We know that any drug that's present in your blood may transfer into your breast milk. Therefore, if an injector were to inadvertently hit a blood vessel and botulinum were introduced into the blood stream, it is highly likely that it would be transferred into breast milk.
Further, studies show that diffusion of botulinum toxin may occur. "It has been suggested that diffusion of BoNT is influenced by a number of factors such as dose, concentration, volume, rate of injection, needle size, distance of needle tip from the neuromuscular junction, number of injections, target muscle selection, the presence of muscular fascia, the presence of tissue damage at the injection site, muscle contraction following injection, and the protein composition and molecular size of the BoNT formulation."
"Botulinum toxin (BoNT) may diffuse across fascial planes to adjacent muscles or be spread hematogenously. At its extreme, the possible leakage of BoNT into the systemic circulation may manifest as clinical botulism."
Then knowing that botulinum diffusion or leakage may occur even "days or weeks," after treatment, the obvious conclusion should be drawn, that using botulinum toxin injections while lactating poses risk to the baby.
source: Diffusion of Botulinum Toxins
Matthew A. Brodsky, David M. Swope, and David Grimes
Botulinum toxin after Botox has been found in breastmilk samples.
In a recent study that analyzed 16 milk samples, detectible amounts of the toxin were found in 8/16 samples. Although, it was stated that the amounts found, were "well below the reported lethal oral dose for an infant," the question should be,
Is exposure to ANY amount of botulinum toxin A safe for an infant?
The answer is a clear, NO.
No amount of botulinum toxin for an infant is safe. Exposing an infant to botulinum toxin A will only pose a risk to the baby. Botulinum toxin A by definition, is the world's most lethal neurotoxin. [Source.]
Analysis of Breast Milk Samples in Lactating Women After Undergoing Botulinum Toxin Injections for Facial Rejuvenation: A Pilot Study
Should Botox be used while TTC, "trying to conceive"?
The answer is a clear, NO.
You should not use Botox while TTC.
Based on all of the information above, we believe that using botulinum toxin injections while "trying to conceive" is a risk. The benefit of having temporarily smoothed facial lines should not be worth the risk of conception problems, fetal birth defects, harm, or loss.
Again, we know that based on manufacturer supplied warnings that toxin spread may happen days, weeks, or months after injections. Therefore, using botulinum while trying to conceive simply put, is reckless.
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