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Methylcobalamin is distributed into breast milk in amounts similar to those in maternal plasma, and distribution in breast milk allows for adequate intakes of methylcobalamin by breastfeeding infants

[6] In all cases, a healthcare provider should evaluate patient history for any contraindication before initiating therapy

Consult your healthcare provider before starting any new treatments during pregnancy or breastfeeding

When to increase dose Consider increasing if: Minimal response after 4-6 weeks at current dose No side effects at current dose Current dose below the higher end of recommended range Goals not being met with conservative approach Increase gradually, typically by 25-50% at a time