Is Latisse Safe When Breastfeeding?
Latisse (bimatoprost 0.03%) may be considered for use during breastfeeding, as prostaglandin analogs like bimatoprost are generally regarded as acceptable options for lactating mothers, though data on excretion into human breast milk remains limited. 1
Evidence from Ophthalmology Guidelines
The American Academy of Ophthalmology's 2021 guidelines specifically address prostaglandin analogs (the drug class to which bimatoprost belongs) in breastfeeding mothers:
Prostaglandin analogs may be considered for use in the breastfeeding mother, distinguishing them from pregnancy where they are generally avoided due to theoretical risk of premature labor. 1
This recommendation applies to the entire prostaglandin analog class, which includes bimatoprost (the active ingredient in Latisse). 1
FDA Drug Label Information
The official bimatoprost FDA label provides important context:
It is not known whether topical ocular treatment with bimatoprost could result in sufficient systemic absorption to produce detectable quantities in human milk. 2
Animal studies showed bimatoprost present in rat breast milk at intravenous doses 324 times the recommended human ophthalmic dose, but no animal data exists at clinically relevant doses. 2
The label recommends considering "the developmental and health benefits of breastfeeding along with the mother's clinical need for bimatoprost and any potential adverse effects on the breastfed child." 2
Clinical Reasoning
The favorable assessment for breastfeeding use is based on several pharmacologic principles:
Topical ophthalmic administration results in minimal systemic absorption, with peak blood concentrations of only 0.08 ng/mL occurring within 10 minutes and falling below detection limits (0.025 ng/mL) within 1.5 hours in most subjects. 2
The extremely low systemic exposure makes clinically significant transfer into breast milk unlikely. 2
Unlike brimonidine (which crosses the blood-brain barrier and can cause apnea and somnolence in infants and is contraindicated in breastfeeding), prostaglandin analogs do not have this mechanism of concern. 1
Practical Application Strategy
When prescribing Latisse to a breastfeeding mother:
Apply the medication immediately after breastfeeding or just before the infant's longest sleep period to minimize any theoretical infant exposure. 3, 4
Use proper application technique with a single drop to the upper eyelid margin to minimize systemic absorption. 2
Monitor the infant for any unusual symptoms, though adverse effects are not expected given the minimal systemic exposure. 3
PCOS Context
The patient's history of PCOS does not alter the safety assessment for Latisse during breastfeeding:
PCOS itself does not contraindicate bimatoprost use. 1
Breastfeeding may actually provide metabolic benefits for women with PCOS, including improved insulin sensitivity and reduced future NAFLD risk. 1
Critical Caveats
Do not confuse cosmetic use (Latisse for eyelash growth) with therapeutic glaucoma treatment—while the medication is identical, the risk-benefit calculation differs. For cosmetic use, the "mother's clinical need" is elective, which should factor into shared decision-making. 2
Avoid brimonidine-containing products during breastfeeding, as this alpha-agonist can cause serious respiratory depression in infants—this is a completely different drug class from bimatoprost. 1
Long-term pigmentation changes (periorbital skin, eyelashes, iris) can occur with bimatoprost use, though these are maternal cosmetic concerns rather than infant safety issues. 5
Human data on bimatoprost in breast milk remains absent, so this recommendation relies on pharmacokinetic principles, animal data, and class-wide guideline statements rather than direct human lactation studies. 2, 3