Another question not frequently asked but something I have been meaning to write for ages. Hope it helps for those who need to have this procedure.

Scleratherapy and Breastfeeding Factsheet

Sclerotherapy is a means of treating varicose veins.

Varicose veins are swollen and enlarged veins that usually occur on the legs and feet. They may be blue or dark purple, and are often lumpy, bulging or twisted in appearance. They can occur after pregnancy. Other predisposing factors are being overweight, having a job that involves a lot of standing and being female. Women seem to get the short straw in many ways.

In a healthy vein, blood flows smoothly to the heart. The blood is prevented from flowing backwards by a series of tiny valves that open and close to let blood through. If the valves weaken or are damaged, the blood can flow backwards and collect in the vein, eventually causing it to be swollen and enlarged.

Symptoms

• aching, heavy and uncomfortable legs
• swollen feet and ankles
• burning or throbbing in your legs
• muscle cramp in your legs, particularly at night
• dry, itchy and thin skin over the affected vein

If treatment is necessary, using compression stockings, taking regular exercise and elevating the affected area when resting may be recommended first line.

The most common further treatment options include:

• endothermal ablation – where heat is used to seal affected veins
• sclerotherapy – this uses special foam to close the veins
• ligation and stripping – the affected veins are surgically removed

It’s unlikely treatment on the NHS for cosmetic reasons is available but has to be sought privately.

Breastfeeding and sclerotherapy

Sclerotherapy is the procedure which seems to give rise to questions about breastfeeding. The treatment involves injecting special foam into your veins. The foam scars the veins, which seals them closed. As well as the foam the procedure involves the injection of a local anaesthetic.

The agent injected into the veins is usually Sodium Tetradecyl Sulphate. It is a modified version of sodium lauryl sulphate, a common ingredient in toothpaste, shampoo, and dish soap. Trade names include Fibro-Vein™, Sotradecol™, Trombovar™.

No data on excretion into breastmilk nor are pharmacokinetic data available, but toxicity is expected to be low. Breastfeeding can be resumed a few hours after the procedure (Hale). Like others sclerosing products used to treat varices it does not trespass into the blood stream in significative amounts nor the breast milk when applied properly. (Elactancia)

References

Elactancia https://e-lactancia.org/breastfeeding/sodium-tetradecyl-sulfate/product/

Hale TW Medications and Mother’s Milk Springer Publishers

NHS Varicose Veins https://www.nhs.uk/conditions/varicose-veins/