From the Guidelines
It is recommended to avoid using topical retinol while breastfeeding due to the theoretical risk of the active ingredient passing into breast milk and potentially affecting the nursing infant. Although topical retinoids like retinol have limited systemic absorption compared to oral forms, the safety of retinol during breastfeeding has not been well-studied, and healthcare providers typically advise erring on the side of caution 1.
Key Considerations
- The limited systemic absorption of topical retinoids does not completely eliminate the risk of the active ingredient entering breast milk.
- There is a lack of comprehensive studies on the safety of retinol during breastfeeding, making it prudent to avoid its use.
- Alternatives such as vitamin C serums, niacinamide, hyaluronic acid, or azelaic acid have better safety profiles during lactation and can address similar skin concerns like hyperpigmentation, texture, and hydration.
Alternatives for Skincare Concerns
- Vitamin C serums: beneficial for brightening and antioxidant properties.
- Niacinamide: improves skin elasticity and hyperpigmentation.
- Hyaluronic acid: enhances skin hydration.
- Azelaic acid: mildly effective as a comedolytic, antibacterial, and anti-inflammatory agent, and is category B in pregnancy, making it a safer option during breastfeeding.
Recommendation
If you feel strongly about using retinol while breastfeeding, it is essential to consult with your healthcare provider and dermatologist to discuss your specific situation and potential risks. However, based on current evidence and the principle of caution, avoiding topical retinol during breastfeeding is the recommended course of action 1. Once breastfeeding is completed, retinol products can be safely reintroduced into the skincare routine.
From the Research
Safety of Topical Retinol During Breastfeeding
The safety of using topical retinol while breastfeeding is a concern due to the potential transfer of retinoids to the infant through breast milk.
- The transfer of medications into breast milk depends on a concentration gradient that allows passive diffusion of nonionized, non-protein-bound drugs 2.
- There is limited data available regarding the topical application of drugs to breast, nipple, or areolar tissue, and the absorption of therapeutic agents applied to the breast may be of concern in the breastfed infant 3.
Topical Retinoids and Breastfeeding
While there is limited research on the use of topical retinoids during breastfeeding, some studies suggest that the risk of adverse effects may be low.
- The available, but limited, epidemiologic data show little-to-no teratogenic potential associated with real-life use of topical retinoids in humans 4.
- However, it is recommended that the use of topical retinoids during pregnancy be avoided, and it is unclear whether this recommendation extends to breastfeeding 4.
- Breast milk is rich in retinoids, and prolonged lactation reduces maternal stores of retinoids, which may have evolutionary-adaptive functions for both mother and infant 5.
Precautions and Considerations
When considering the use of topical retinol while breastfeeding, it is essential to weigh the benefits and risks.
- The safety of each individual agent should be assessed prior to application to the breast while nursing 3.
- Mothers of premature or otherwise compromised infants may require altered dosing to avoid drug accumulation and toxicity in these infants 2.
- The most accurate and up-to-date sources of information should be used to inform decisions about medication use during breastfeeding 2.