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Therefore, parenteral cyanocobalamin should be administered to a pregnant woman if the benefits outweigh the risks.[15][16] Cyanocobalamin is excreted in the breast milk of nursing women in levels similar to the level of vitamin B12 in maternal plasma.[25] The distributed cyanocobalamin in breast milk has been found to be compatible with breastfeeding by the American Academy of Pediatrics.[26] In addition, there has not been any reports of adverse effects associated with the intake of normal daily requirements of vitamin B12 during lactation

Test for candida or dysbiosis if GI symptoms persist

doi: 10.1684/ejd.2014.2436 49 KodydkovJVvrovLKockMkA

In some cases, 2 days of prep diet may be needed to sufficiently reduce baseline gases to negative

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Meyer, K.F