Botanicals During Lactation

I've had some patients recently ask me about taking botanicals during lactation so I decided to write up a short excerpt on the subject as a frame of reference. As always, I invite you all to comment with your own personal knowledge and experience on this topic.

All my best,

Dr. G

Botanicals During Lactation

Georgia Tetlow, MD

Women around the world have traditionally relied upon herbal medicine to address specific concerns when they are lactating. Scientific evaluation has not been undertaken for the vast majority of these herbs but a number are often widely recommended. Herbs commonly mentioned in the herbal literature for enhancing the production of breast milk (lactagogues) include aniseed, borage, caraway seeds, cinnamon, comfrey, dill, fennel seeds, fenugreek, goat’s rue, marshmallow, milk thistle, blessed thistle, nettles, raspberry leaves, as well as chastetree. Aniseed, caraway seeds, cinnamon, dill, and fennel seeds are all aromatic spices that can be easily and safely added to foods. Raspberry, nettle, marshmallow and fenugreek are quite benign and can be consumed in tea by nursing mothers if they choose. Comfrey and borage are contraindicated for nursing mothers because these herbs contain pyrrolizidine alkaloids, substances that have the potential to cause liver damage and have been shown to cross into breast milk. The list below contains herbs generally recognized by botanical experts as being unsafe during lactation. This list should not be considered exhaustive, as many herbs have yet to be adequately studied; many botanical medicine experts, as well as I, err on the side of caution and are very careful in the use of plants during lactation.

Herbs to be avoided while breastfeeding

This list has been comprised from numerous authoritative sources, however, it may not be complete and practitioners should always err on the side of caution.

• Aloe vera latex (not juice) (Aloe spp.)
• Black cohosh (Actaea racemosa)
• Bladderwrack (Fucus vesiculosus)
• Blue cohosh (Caulophyllum thalictroides)
• Borage (Borago officinalis)
• Buckthorn fruit (Rhamnus cathartica)
• Bugleweed leaf (Lycopus spp)
• Cinchona bark (Cinchona spp)
• Cola seeds (Cola nitida)*
• Coltsfoot leaf (Tussilago farfara)
• Comfrey leaf/root (Symphytum officinale)
• Ephedra (Ephedra spp.)
• Guarana (Paullinia cupana)*
• Jasmine flowers (Jasminum pubescens)
• Kava (Piper methysticum)
• Madder root (Rubia tinctorum)
• Ma Huang (Ephedra sinica)
• Pulsatilla (Anemone pulsatilla)
• Queen of the Meadow root/herb (Eupatorium purpureum)
• Senecio (Senecio aureus)
• Wormwood herb (Artemesia absinthium)

*Guarana and cola are included on this list principally because of caffeine content, though small amounts would be no more likely to cause agitation in the baby than similar amounts of caffeine found in coffee or tea.

Disclaimer: All information contained in this article is intended for informational and educational purposes only, and is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition.  If you need specific medical advice, please contact your primary care physician or our office for appointment.  If you have a medical emergency, call 911 immediately.