Botox without knowing?

[Lemonlove26]

Hi all, last week I found out I was 4 weeks pregnant and the week before that I got 20 units of Botox in my forehead. I had no idea I was pregnant at that stage! Riddled with guilt atm worrying about the effects on the baby. Anyone made this error before and had uncomplicated pregnancies and healthy babies? Thanks :)

It would be very unlikely to have any effect as botox is given locally and was nowhere near your abdomen. The foetus also won't be getting nourished by the placenta at this stage so nothing can pass that way either.

You and baby willl be fine.
20units is a tiny amount. Unlikely to have
A) got into your bloodstream
B) be enough to cause any problems

And congrats on your pregnancy x

I read a substack by Emily Oster on this topic which is quite reassuring (although personally I wouldn't get botox while pregnant a second time).

Here it is, hope it makes you feel better!

In people, what we have are small samples or case series. And they are uniformly reassuring. We have, for example, one studyy of 45 patients with chronic headaches who were treated and became pregnant. There were no negative outcomes. A retrospective revieww of 232 exposures over 24 years showed no differences in pregnancy and baby outcomes relative to what would be expected without exposure. Beyond these, we have various individual reports and case series (like this onee and this onee), all of which are reassuring.
There are also a few case reports of mothers with botulism poisoning — this is illness from either tainted food, or heroin use — which do not suggest negative impacts for the fetus. As in the breastfeeding case, this is very reassuring, because obviously a dose sufficient to poison the pregnant person is far, far higher and more systematic than the dose used in cosmetic or medical applications. The reassuring data is supported by general biology. Botox injections are a low concentration of a toxin, and localized. It seems unlikely that they would impact the fetus.
What we do not have is either a large randomized trial or a large prospective study (like you’d have with something like Tylenol, with millions of exposures). This makes it hard to rule out concerns about low-probability events. Like, if there was a 1-in-1,000 or 1-in-10,000 risk, we wouldn’t pick it up in the samples we see.
So there it is: as is often true in pregnancy, we cannot be sure there are not small risks. There are always small risks — riding in a car, for example — that we live with. As with most of the data I talk through about pregnancy, decisions will come down to weighing the evidence, the possible risks and the benefits.

Ahh thank you all! Feeling a lot more at peace now. Really appreciate your responses x