The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is botulism during pregnancy?

Botulism is a condition that is characterized by paralysis, caused by botulinum toxin that is produced by the bacterial species Clostridium botulinum. Exposure to botulinum toxin can come from ingesting contaminated food, notably homemade foods that have been canned or preserved incorrectly. It also can come from C. botulinum spores in a wound, from spores in the intestines, or an injection of too much botulinum toxin given for the treatment of certain conditions, such as migraine, or wrinkles. Botulism is rare, but foodborne and wound botulism are the most likely types to occur in pregnant women.  

How common is botulism during pregnancy?

In the United States, approximately 100 to 150 cases of botulism occur each year. Of these, only a fraction occurs in pregnant women. A review of the medical literature in 2017 looking at the effects of pregnancy and post-partum botulism on mothers and babies identified only 17 cases, 10 of which were foodborne botulism, two from wound contamination during heroin injection, and 5 of unknown origin.

How is botulism during pregnancy diagnosed?

Diagnosis of botulism begins with physical examination with emphasis on the neurological exam, looking for muscle weakness or paralysis, with signs such as weakness in the voice or droopy eyelids and a weak voice. This plus a discussion about your recent history that may have included consumption of potentially contaminated food, or possible exposure to C. botulinum in a wound. Some researchers suggest that doctors should maintain a particularly high level of suspicion for botulism when it comes to women who are pregnant or in the postpartum period, not because the disease is common but because such women may be more susceptible than others and possibly experience a more extreme clinical course. Suspicion of botulism will initiate a process that will lead to laboratory testing of potential sources of contamination, which may involve government agencies, such as local public health departments.

Does botulism cause problems during pregnancy?

Initial paralytic symptoms can include trouble with vision, swallowing, speaking, or keeping the eyelids open, blurred vision, and double vision, plus the person may experience dry mouth and facial weakness. Symptoms of foodborne botulism typically begin 12 to 36 hours after ingestion of the contaminated food, whereas wound botulism can take several days. In either case, paralysis can reach the point of preventing the person from being able to breathe, in which case the condition will be fatal unless the person is put on mechanical ventilation.

Does botulism cause problems for the baby?

The babys life is in danger, firstly because the mothers life is in danger. Due to the small number of cases, it is not possible to know all possible effects on the baby, but the medical literature review found that 6 of the 17 women delivered preterm infants.

What to consider about taking medications when you are pregnant or breastfeeding:

  • The risks to yourself and your baby if you do not treat the botulism
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat botulism during pregnancy?

Botulism can be treated with an injection of botulism antitoxin. This agent consists of antibodies or parts of antibodies that attach to the botulinum toxin and block its effects. In cases of wound botulism, antibiotics can be given as an additional treatment to confront any C. botulinum that may still be growing in the wound and thus producing toxin. Antibiotics are not useful in foodborne botulism because the toxin has all come from the food that the person has ingested, and no more toxin is being produced.

Who should NOT stop taking medication for botulism during pregnancy?

If you have botulism, the injected antitoxin is necessary and offers the best chances for survival. If you are put on an antibiotic for wound botulism, you need to complete the course of the prescribed regimen.

What should I know about choosing a medication for my botulism during pregnancy?

It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.

You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.

What should I know about taking a medication for my botulism when I am breastfeeding?

There have not been enough cases of post-partum botulism for the issue of antitoxin and breastmilk to be studied. However, it is not likely that the antitoxin would harm a nursing infant even it does pass into breastmilk. As for the botulinum toxin itself, it is not thought to enter breastmilk.

What alternative therapies besides medications can I use to treat my botulism during pregnancy?

Generally, a pregnant woman suffering from botulism would be admitted into the intensive care unit and put on mechanical ventilation. This is not an alternative but in addition to treatment with the antitoxin.

What can I do for myself and my baby when I have botulism during pregnancy?

Accept the anti-toxin and other treatments that are offered. This is a potentially fatal condition and therapy must begin very quickly.

Resources for botulism in pregnancy:

For more information about botulism during and after pregnancy, contact (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations:

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Last Updated: 13-01-2020
General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.

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