3 Safety Hacks for Moms Taking Herbs While Breastfeeding

This time of year EVERYBODY is sick - a reality that makes this breastfeeding mom want to make a nice soft nest and hide my baby there until Spring to keep her safe! Anyone else feel that way? This post is for every breastfeeding mom who has ever wondered what herbs are safe to take. I've had the same question... and it was suddenly very important to find the answer when my daughter Ada caught a cold at 3 weeks old. Talk about SCARY for a first time mom!

So, here's some things to think about when you or your baby start to catch a cold and you're deciding on what herbal treatment you'll use to ward it off.

1. Consider Baby's Developmental Stage

Babies' age and stage of development plays the biggest role in what their little bodies can handle as far as medications and food goes - and of course, it is the same with herbs. For the first two weeks of life, a newborn’s liver cannot metabolize chemical constituents nearly as well, and larger molecules can pass through the milk ducts and to baby. After those first two weeks, it is believed that from a molecular and percentage standpoint, ingested herbal compounds (with the exception of iodine and alkaloids) do not enter and/or concentrate in the milk duct in anything but minute amounts. The expectation generally accepted for pharmaceuticals is that 1% of the maternal dose of a medication will enter the milk – and Aviva Romm suggests there is no reason to think that the reality would be any different in regard to herbal medicine and its effects (BMFWH, 2^nd Ed, pg. 466). A conservative herbalist (such as myself) might assume that the range is more like 1-10%, for the purpose of erring on the side of caution.

Topical use of essential oils may be different in that, if it is also commonly accepted that if a chemical is not absorbed into the bloodstream through the GI tract, then it cannot reach the breast (pg. 467), then it is theoretically possible that they can be used on mother’s skin and never enter breast milk. This is true only so long as the oil is not placed directly on the breast, however – if it is, it will most certainly end up in breast milk through the process of diffusion. Tea tree, peppermint, camphor, neroli and cajeput oils in particular are known to be the cause of respiratory collapse in infants, and should be strictly avoided (Blumenthal et al, 1998).

2. Know Which Ones to Absolutely AVOID

The above being said, we cannot throw caution to the wind. Herbs that still pose a risk to baby due to their molecular size include:

·        Stimulant laxatives (which are documented to be able to cause loose stools in the infant [Hale, 2002]).

·        AA- or toxic PA-containing herbs (since these are known to cause adverse effects in adults when used appropriately, it can be expected that they could also cause such for infants – although the possible extent of those side effects on baby is unknown due to lacking studies).

·        CNS-stimulants such as coffee, tea, cola, yerba mate, guarana and chocolate (which cause over-stimulation, hyper-alertness and restlessness in infants).

·        And any herbs that cause an allergenic or anaphylactic response in the mother (as this can be passed on to baby).

Herbs that pose a risk to lactation itself (and therefore baby, since proper breast milk production is equal to baby’s nourishment!) include:

• Sage
• Parsley 
• Ephedra 
• ...among others.

Mills and Bone are of the opinion that most herbs are safe for use in lactation, given they are used properly; however, they list the following herbs as having “SD” (strongly discouraged) status:

• Barberry and Indian barberry
• Bearberry
• Bittersweet
• Black cohosh
• Elecampane
• Ephedra
• Goldenseal
• Greater celandine
• Guggul
• Jamaican dogwood
• Oregon grape
• Pasque flower 
• Willow bark

They also list these herbs as having “X” (contraindicated) status:

• Arnica
• Blue cohosh
• Boldo
• Bugleweed
• Gypsywort
• Chaparral
• Pennyroyal
• Poke root
• Sage
• Tansy
• Thuja
• Tylophora 
• Wormwood 

(See: EGHS, Appendix A, pg 647). They also have other herbs categorized under “ND” (No Data Available), “C” (Compatible with breastfeeding) and “CC” (Compatible with breastfeeding but use caution).

3. Play it Safe with THESE Guys

So we've talked about the big no-no's - so which ones ARE safe?  The answer is complicated. As you'll find if you read more of my website, I feel it is beneficial on a number of levels for moms to take it upon themselves to personally research medical decisions they're making for their families, instead of relying on one person or organization to give them quick answers. No matter how many years we've studied, none of us have all the information... there's always opportunity to learn from those with alternative perspectives and vantage points! So, my answer is first and foremost: whenever you are thinking about taking an herb yourself or giving it to your child, take a minute to google a handful of trustworthy herbal resource sites and read through their indications/contraindications section (I have a list of such sites on my resource page). This will help you rule out any reasons why you should not follow through with that option - and give you a heaping, awesome-feeling dose of confidence in your decision!

Once you've done that... I can now give you my list of herbs that are generally regarded as completely safe for you to take while breastfeeding (and YAY! There's so many!!):

• All the pregnancy tonic herbs: alfalfa, red raspberry leaf, nettle, oatstraw.
• Ashwagandha
• Astragalus
• Echinacea
• Elderberry
• Ginger
• Garlic
• Chamomile
• Turmeric
• Lavender 
• Valerian
• Passionflower
• Fenugreek
• Blessed thistle (take care with these last two, as they WILL increase your milk output!)
• Spearmint
• Peppermint
• Schinsandra
• Burdock
• Dandelion
• Yarrow
• ...and the list goes on. (See end of article for complete list).

Now again - these are not necessarily safe for YOUR BABY to ingest, but because of the minute amount of herbal properties that actually ends up in your breastmilk, YOU are safe to take these without risk of harming your child. In fact, until my child is two years of age, I prefer to medicate her through my breastmilk instead of directly. There's no safer way to do it, ya'll!

So, if you or your baby are coming down with a cold or flu, you DEFINITELY have options as far as herbal treatment. My protocol varies depending on what we are fighting, but it always includes these things: 

• Elderberry syrup (Just elderberries, ginger, cinnamon, cloves and raw local honey. Safe for me, safe for Ada!)
• Echinacea tincture
• Immune-boosting tea (A blend I make myself that includes: peppermint, astragalus, ginger, yarrow, marshmallow root and elderberry).
• Zinc
• Vitamin C

What would you try? Let me know in the comments!!

A Quick Note on Herbs for PPD (Postpartum Depression):

I want to address this because for those dealing with PPD, getting help (and promptly) can be very important - and the decision of whether to go the medical or natural route can be difficult to make if you're at the point that you're completely overwhelmed (and understandably so!) and just want to get on SOMETHING. Of course, antidepressants are the first thing that would be prescribed in a conventional medical setting - but there are definite risks involved for mother and baby alike in taking these drugs. In fact, Chambers et al found an association between antidepressant use in the last trimester and persistent pulmonary hypertension in the newborn. Side effects of sedation, somnolence, colic, jitteriness, respiratory arrest and withdrawal have also been noticed in infants whose mothers were simultaneously breastfeeding and taking antidepressants (Hale, 2004). 

I personally believe there to be many ways to address depression apart from drugs, and that drugs should be used as a last resort. Increasing the time mom spends in community, particularly serving others or encouraging/being encouraged, and being sure to surround herself with supportive friends and family, is essential. Isolation, and the loneliness and internalizing it causes, breeds depression. Ensuring mom’s diet is rich in nutrients and high enough in calories, that she is getting proper amounts of vitamins and minerals from a quality prenatal, that she is avoiding foods and beverages that exacerbate anxiety, that she is regularly checked for signs of anemia, that she is supplementing with EFA’s (particularly Omega-3’s and GLA) and possibly a magnesium/calcium blend, that her blood sugar levels are being regulated and supported by snacks every 2 hours, that she is getting exercise and sunshine, and that we are treating any fatigue/insomnia with gentle sedative herbs (Romm suggests a blend of milky oats, chamomile, lavender and lemon balm – BMFWH, pg 456) can go a long way. It may take some time to see results, but it would also take time before we’d see an antidepressant take effect. If the depression were to get out of hand, and mom is in serious need of greater help (and quickly), St John’s Wort would be my next line of defense. This is not ideal, as although SJW is not currently contraindicated in pregnancy, safety studies are lacking. But as evidenced in a Cochrane review in 2008, it is proven “superior to placebo in patients with major depression; SJW as effective as antidepressants for depression; SJW has fewer side effects than standard antidepressants” (BMFWH, pg 454). If it is used, care must be taken that SSRI’s and MAOI’s are not taken concurrently, as their effects would be greatly potentiated (McIntyre, 2000).

A Christian counselor, pastor, female mentor or mom support group would be my recommendation if further help was needed. 

Conclusion

No pharmaceutical or herbal medication should be taken carelessly or thoughtlessly during lactation. As always, care should be taken by each of us to research the herbal options demonstrating a certain action, and make sure whatever route we take is both the safest and most effective of the available options for the desired outcome. Mills and Bone (wisely) warn that “The full safety profile of any herb to be used during pregnancy or lactation needs to be carefully considered and should only be used when benefit exceeds risk” (EGHS, pg 21)... in a nutshell, this simply means: if there's an herb you're iffy on taking due to a lack of studies, be conservative and pick a different, more neutral herb. It's better to be safe than sorry - especially when your child is concerned. And since every infant is an individual, one may react or respond to a medication (herbal or otherwise) differently than others - allergic reactions to herbs, while extremely rare, can happen. So - of course - moms taking herbs while breastfeeding should watch their babies carefully and lower their dose or stop taking the formula immediately if she notices baby responding adversely/nursing less/sleeping more, etc.

All the necessary cautions aside (*wink*) - do some research, gather those herbs, and enjoy the deep nourishment your body is receiving when you use the amazing healing plants God's provided for us! 

Did this encourage you to try herbal therapies, even while breastfeeding? Did it dispel any fears for you?