Breastfeeding and herbal medicines

Herbal medicines should be approached with caution when you are breastfeeding.

Like any medication there should be a clear indication for the use of herbals. Conventional medicines should be considered first as there is more information on the safety profile of such drugs.

What are herbal medicines?

Herbal medicines are produced from plants and are based on traditional knowledge. They are examples of complementary and alternative medicines (CAM). CAM also include therapies such as acupuncture, dietary supplements, massage, aromatherapy, homeopathy and relaxation therapy. Read more about complementary and alternative medicines (CAM).

Herbal and traditional medicines are generally bought from pharmacies, supermarkets and health food stores, or may be recommended by a naturopath, a Chinese doctor or another kind of healthcare provider. While most complementary medicines are used to relieve the symptoms of minor ailments, many are used for maintaining health and wellbeing.

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What are the concerns about taking herbal medicines while breastfeeding?

There is a need for more research on the efficacy and safety of all herbal preparations by breastfeeding mothers. Most herbal medications are poorly regulated and as a result, the level of active ingredients and possibly harmful ingredients may be unknown in a specific product. Such inconsistencies can lead to differences in efficacy and safety of products, making it difficult to use when you are breastfeeding.

Caution should be used when considering herbal and traditional medicines, especially when your infant is a newborn or if born prematurely. You and your healthcare provider can look up the safety of your medications using a trusted online database such as LactMed.

Common herbal and traditional medicines

The following are examples of common herbal and traditional medicines that may be used during breastfeeding.

Herbal medicine Description and what to watch out for
Aloe vera
  • Aloe vera gel is sometimes used to help heal cracked nipples.
  • Remove aloe gel from the nipple areas before feeding your baby because the bitter taste of the aloe vera gel can affect feeding.
  • Aloe vera latex is a yellow-coloured liquid that comes from the inner skin of the aloe leaf. It is taken by mouth (swallowed) in both the dried and liquid form. Avoid taking aloe vera latex as it has a strong laxative effect and causes runny poo (diarrhoea).
Cranberry
  • Cranberry is sometimes used to prevent urinary tract infections in breastfeeding mothers.
  • If you are breastfeeding you should avoid cranberry if you are taking any anti-coagulant medicines (medicines that prevent blood clots).
Echinacea
  • Echinacea is sometimes used to treat or prevent upper respiratory tract infections.
  • If you take echinacea while breastfeeding, watch for possible side effects in your baby, such as diarrhoea or constipation, poor feeding and skin rashes.
  • Read more about echinacea. 
Fenugreek
  • Traditionally fenugreek is used to increase milk production.
  • Fenugreek can cause nausea and vomiting in the mother and diarrhoea (runny poo) for the infant.
Garlic
  • Garlic appears to be safe in amounts usually used in food preparation.
  • Garlic may change the smell of breast milk and affect your baby’s feeding.
Ginger
  • Ginger appears to be safe in amounts usually used in food preparation.
Milk thistle
  • Caution is advised when using milk thistle while breastfeeding as it can act as a laxative or induce an allergic reaction. 
Raspberry leaf
  • When used as a tea, raspberry leaf is considered safe to use while breastfeeding although it may reduce milk production if used for longer than 2 weeks. 
St John’s Wort
  • There is very little information available about the safety and effect of St John’s Wort in breastfeeding women. 
  • It is recommended that an alternative medicine be considered.
  • See your doctor or pharmacist for advice before starting St John’s Wort as there can be drug interactions.
  • Read more about St John's Wort.

References

  1. Herbal medicines & breastfeeding The Royal Women's Hospital, Australia
  2. Nice FJ. Non-prescription Drugs for the Breastfeeding Mother (second edition). 2011, Hale Publishing
Credits: Sandra Ponen, Pharmacist.