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Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
Drug Levels and Effects
Summary of Use during Lactation
Breastfeeding is considered to be a risk factor for infant botulism via direct exposure, possibly because of changes in the intestinal flora during weaning.[1] An epidemiologic study in California in 1976-1978 found the age of onset of the disease to be later in breastfed infants (13.8 weeks) than in formula-fed infants (7.6 weeks) and no breastfed infants died from the disease, whereas 8 cases of sudden death from botulism occurred in formula-fed infants.[2] A subsequent study found no difference is severity between breast- and formula-fed infants.[3] Little information is available on the transfer of the botulinum toxin into breastmilk. Mothers suspected of having botulinum poisoning should not breastfeed until they have recovered.
Drug Levels
Maternal Levels. Type A botulinum toxin was detected in the blood and stools of a nursing mother after ingesting fermented salmon eggs. The mother was given 2 vials of trivalent botulism antitoxin, 1 intravenously and 1 intramuscularly. A milk sample obtained 4 hours after administration of the antitoxin had no detectable botulinum toxin nor botulism organisms.[4]
Infant Levels. Type A botulinum toxin was detected in the blood and stools of a nursing mother after ingesting fermented salmon eggs. No botulinum toxin was detected in the infant's blood or stool on the day the mother was admitted to the hospital and no botulism organisms were detected in the infant's stools.[4]
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
References
- 1.
- Brook I. Infant botulism. J Perinatol. 2007;27:175–80. [PubMed: 17314986]
- 2.
- Arnon SS, Damus K, Thompson B, et al. Protective role of human milk against sudden death from infant botulism. J Pediatr. 1982;100:568–73. [PubMed: 7038077]
- 3.
- Spika JS, Shaffer N, Hargrett-Bean N, et al. Risk factors for infant botulism in the United States. Am J Dis Child. 1989;143:828–32. [PubMed: 2741856]
- 4.
- Middaugh J. Botulism and breast milk. N Engl J Med. 1978;298:343. [PubMed: 622098]
Substance Identification
Substance Name
Botulinum Poisoning
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
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- Protective role of human milk against sudden death from infant botulism.[J Pediatr. 1982]Protective role of human milk against sudden death from infant botulism.Arnon SS, Damus K, Thompson B, Midura TF, Chin J. J Pediatr. 1982 Apr; 100(4):568-73.
- Breastfeeding by HIV-1-infected women and outcome in their infants: a cohort study from Durban, South Africa.[AIDS. 1997]Breastfeeding by HIV-1-infected women and outcome in their infants: a cohort study from Durban, South Africa.Bobat R, Moodley D, Coutsoudis A, Coovadia H. AIDS. 1997 Nov; 11(13):1627-33.
- Review [Breastfeeding in Africa: will positive trends be challenged by the AIDS epidemic?].[Sante. 2002]Review [Breastfeeding in Africa: will positive trends be challenged by the AIDS epidemic?].Dop MC. Sante. 2002 Jan-Mar; 12(1):64-72.
- Review Role of breast-feeding in the prevention and treatment of diarrhoea.[J Diarrhoeal Dis Res. 1990]Review Role of breast-feeding in the prevention and treatment of diarrhoea.Huffman SL, Combest C. J Diarrhoeal Dis Res. 1990 Sep; 8(3):68-81.
- Associations of infant feeding with trajectories of body composition and growth.[Am J Clin Nutr. 2017]Associations of infant feeding with trajectories of body composition and growth.Bell KA, Wagner CL, Feldman HA, Shypailo RJ, Belfort MB. Am J Clin Nutr. 2017 Aug; 106(2):491-498. Epub 2017 Jun 28.
- Botulinum Poisoning - Drugs and Lactation Database (LactMed®)Botulinum Poisoning - Drugs and Lactation Database (LactMed®)
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