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I have a 9 month old baby who breastfeeds frequently day and night. My neurologist recommended taking 400mg of riboflavin daily to prevent migraines. She said it is category L1. However, my concern is that the safety rating she is referring to assumes the usual vitamin dose which is 1.6mg daily. Is there any safety data known about taking 400mg? The alternative medication she would try is propranolol. Is the riboflavin considered a safer option even at the very high dose?
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Hi, thanks for your post.
There are no studies in the medical literature that specifically examine this situation. However, we can put together some well-established facts to paint a picture of 400mg riboflavin (vitamin B-2) being a very safe drug in your situation. First, no toxic dose of this vitamin has ever been documented. Anyone can theoretically overdose on anything, but poisonings with riboflavin simply haven't happened so far. Participants in the trials that established 400mg as an effective dose for migraine prevention reported no side effects from that dose. Second, riboflavin is absorbed from the intestine via a dedicated transport protein. That transporter can only work so fast before it becomes overwhelmed and extra riboflavin gets washed out with the stool. Third, only a small portion of your dose ends up in the breastmilk and that amount still has to get past the same transport protein in your baby's intestine. Fourth, riboflavin is a water-soluble vitamin so excesses are easily eliminated in the urine and do not accumulate in the body tissues. All of these statements point to riboflavin toxicity being HIGHLY unlikely in your baby.
Vitamin B-2 causes a harmless discoloration of the urine that makes it a strikingly fluorescent yellow. I would be very curious to hear what your baby's urine looks like after you start taking the 400mg dose.
We give Propranolol an L2 rating when it comes to breastfeeding safety. Less than 0.5% of the mother's dose is passed to the baby through the milk. Of the beta-blocker family, propranolol is the preferred agent in breastfeeding mothers. There is no additional risk to this medication from taking it alongside high-dose riboflavin, if that's what you and your doctor decide to do.
Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519
-James Abbey, MD -
Thank you, that information was very helpful!
To answer your question, I have been taking the riboflavin and immediately noticed a change in the color of my urine, but my infant's urine has remained its normal color. Very reassuring!Comment
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This is from awhile ago so I just wanted to be sure that the guidance hasn’t changed.
Also when I took 400 mg of riboflavin, the color of my breast milk changed to yellow. Is that any kind of red flag?Comment
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FTM:
yes, the fact that it(riboflavin) shows up in your urine means your infant is getting some of it. This dose is totally out of reason since the normal oral dose is 1-2 mg per day.
I'd drop you dose to a reasonable range of much less than 100 mg per day.
Tom Hale PhD.Comment
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