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Amanita Mushroom Poisoning use while Breastfeeding

Medically reviewed by Drugs.com. Last updated on Dec 23, 2020.

Amanita Mushroom Poisoning Levels and Effects while Breastfeeding

Summary of Use during Lactation

Amatoxins are water soluble, heat stable polypeptides found in Amanita (most often Amanita phalloides ), Galerina and some Lepiota species. The main toxin from the species A. phalloides is alpha-amanitin, a cyclic octapeptide. It is a potent inhibitor of RNA polymerases that blocks the production of mRNA and protein synthesis in liver and kidney cells.[1] Although some articles and textbooks state that amatoxins pass into breastmilk, the only two well documented cases indicate that they do not pass into milk. Nevertheless, mothers suspected of having mushroom poisoning probably should not breastfeed until they have recovered or toxicologic screening of the breastmilk has ruled out amatoxin.

Drug Levels

Maternal Levels. A 32-year-old mother shared a meal of foraged mushrooms (Amanita bisporigera), and developed symptoms 15 hours post-ingestion. Amatoxin was undetectable in the milk, although the timing of the milk sample was not stated.[2]

A 33-year-old woman picked about 200 mushrooms in the forest in France. She cooked and ate some of them, then breastfed her 5-month-old daughter 3 times a day over the next 36 hours. The mushrooms were identified as mainly Amanita phalloides along with Paxillus involutus, Amanita rubescens, and Chlorophyllum rhacodes. The mother’s urine collected in the emergency department was positive for amatoxin. A breastmilk sample collected 41 hours postingestion had no detectable amatoxin by LC-MS/MS.[3]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

A 32-year-old mother shared a meal of foraged mushrooms (Amanita bisporigera), and developed symptoms 15 hours post-ingestion. She presented to the emergency department 29 hours post-ingestion and was found to have markedly elevated liver enzymes. Her 4 month-old-daughter had breastfed 4 hours post-ingestion. The asymptomatic infant was evaluated 48 hours after breastfeeding and discharged from the emergency department with no evidence of hepatotoxicity.[2]

A 33-year-old woman picked about 200 mushrooms in a forest in France. She cooked and ate some of them, and developed nausea, vomiting and diarrhea 11 hours post-ingestion. She was admitted to the hospital for treatment and had elevated liver enzymes. She had breastfed her 5-month-old daughter 3 times a day over the 36 hours after mushroom ingestion. Her daughter was hospitalized, but did not present any symptoms, nor any biological disturbance.[3]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

References

1.
Hydzik P, Bielanski W, Ponka M, et al. Usefulness of 13C-methacetin breath test in liver function testing in Amanita phalloides poisoning; breast feeding woman case. Clin Toxicol (Phila). 2008;46:1077–82. [PubMed: 18821093]
2.
Shively RM, Nogar JN, Rella JG, et al. Got milk? A case series of an amatoxin-exposed family, including a breastfeeding mother and infant. Clin Toxicol (Phila). 2020;58:148–9. [PubMed: 31070058]
3.
Galland J, Bourdic F, Yaouanc B, et al. Comment on Got milk? A case series of an amatoxin-exposed family, including a breastfeeding mother and infant. Clin Toxicol (Phila). 2021:1–2. [PubMed: 33475424]

Substance Identification

Substance Name

Amanita Mushroom Poisoning

CAS Registry Number

11030-71-0 23109-05-9 58250-15-0

Drug Class

Breast Feeding

Lactation

Foodborne Diseases

Poisoning

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Further information

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