Last update: Nov. 24, 2014

Botulinum B Toxin

Low Risk for breastfeeding


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

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.

Alternatives

We do not have alternatives for Botulinum B Toxin.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Botulinum B Toxin is also known as Botulinum Toxin. Here it is a list of alternative known names::


Tradenames

Main tradenames from several countries containing Botulinum B Toxin in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 150.000 daltons
T1/2 4 hours

References

  1. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  2. Wataganara T, Leelakusolvong S, Sunsaneevithayakul P, Vantanasiri C. Treatment of severe achalasia during pregnancy with esophagoscopic injection of botulinum toxin A: a case report. J Perinatol. 2009 Abstract Full text (link to original source) Full text (in our servers)
  3. Matsumura T, Fujinaga Y, Jin Y, Kabumoto Y, Oguma K. Human milk SIgA binds to botulinum type B 16S toxin and limits toxin adherence on T84 cells. Biochem Biophys Res Commun. 2007 Abstract
  4. Mari Nevas. Clostridium Botulinum in honey production with respect to infant botulism. Academic Dissertation. Faculty of Veterinary Medicine, University of Helsinki. 2006 Full text (link to original source) Full text (in our servers)
  5. [No authors listed] Botulinum toxin. Consens Statement. 1990 Abstract
  6. Arnon SS. Breast feeding and toxigenic intestinal infections: missing links in crib death? Rev Infect Dis. 1984 Abstract
  7. Morris JG Jr, Snyder JD, Wilson R, Feldman RA. Infant botulism in the United States: an epidemiologic study of cases occurring outside of California. Am J Public Health. 1983 Abstract Full text (link to original source) Full text (in our servers)
  8. Arnon SS, Damus K, Thompson B, Midura TF, Chin J. Protective role of human milk against sudden death from infant botulism. J Pediatr. 1982 Abstract
  9. Middaugh J. Botulism and breast milk. N Engl J Med. 1978 Abstract
  10. Knox JN, Brown WP, Spero L. Molecular weight of type a botulinum toxin. Infect Immun. 1970 Abstract
  11. Boroff DA, Dasgupta BR, Fleck US. Homogeneity and molecular weight of toxin of Clostridium botulinum type B. J Bacteriol. 1968 Abstract

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