I spoke with one the experts here at the NIH who uses botulinium.
She stated that the type that this patient would be taking is the BoTox A as it
is given every six months.  In addition, the only Type F left is here at the
NIH. Also, type B is not approved for use yet.
From her clinical experience, most of the botox should be gone from the body
within hours and very little would be in the breastmilk, BUT NEONATAL botulism
can be fatal, so it is not worth exposing a neonate to any possibility.  There
are solutions:
1.      This is an elective procedure; wait to give the botox as late as
possible to at least avoid the neonatal stage.
2.      Establish the breastfeeding first, then give the injection, and pump and
dump for 48 hours if still in the neonatal period.  The expert felt that if
given in the neonatal period, the time should be 48 hours, not 24 hours.
3.      If given after the neonatal period, I would suggest that when the mother
gets the botox that she pump and dump for about 3-4 hours after the injection.
4.      The later the mother elects to get the botox, of course, the better.

Frank J. Nice, DPA, CPHP