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Use a thin needle: Stick to 25G or higher to avoid damaging the rubber stopper

Important counseling points are listed below

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

Kaidery NA, Banerjee R, Yang L, Smirnova NA, Hushpulian DM, Liby KT et al (2013) Targeting Nrf2-mediated gene transcription by extremely potent synthetic triterpenoids attenuate dopaminergic neurotoxicity in the MPTP mouse model of Parkinsons disease