Botox while breastfeeding is likely low risk, especially when used in standard cosmetic doses by a trained professional. Available information suggests it stays mostly where it is injected and has very little absorption into the bloodstream, which makes transfer into breast milk unlikely.
Small breast milk studies found either no botulinum toxin or only very tiny amounts after facial Botox injections. These amounts were far below levels expected to harm a baby. Case reports of mothers with botulism also found no toxin in breast milk and no illness in the breastfed infants.
Even so, the research is limited, with very small study groups and little direct follow-up of babies. For this reason, some people may choose to delay elective cosmetic Botox, especially if their baby is premature, very young, or medically fragile.
If Botox is needed for a medical reason, discuss it with your prescribing clinician and your baby’s pediatrician. Avoid getting injections from unlicensed providers, and do not use any medication or cosmetic treatment without professional guidance while breastfeeding.