Complementary medicines & breastfeeding
Some complementary and alternative medicines have very good information about their safety and effectiveness while breastfeeding, others have very little because not enough research has been done on them.
Complementary and alternative medicines usually refer to herbal and traditional medicines that have been developed using traditional knowledge.
A survey conducted by the National Prescribing Service revealed that 65 per cent of Australians had used one or more complementary medicines in the previous 12 months.
Herbal and traditional medicines are generally bought from shops such as pharmacies, supermarkets and health food stores. They may have been prescribed by a naturopath, a Chinese doctor or another kind of health provider. While most complementary medicines are used for the relief of symptoms of minor and self-limiting conditions, many are used for maintaining health and wellbeing.
Like conventional medicines, certain herbal and traditional medicines, can transfer into your breast milk. Some herbal and traditional medicines may be harmful to your baby, while others can affect your breast milk production. Unless you or your practitioner are very sure about a product's effect on breastfeeding, it is important that you do not take that product.
Breast milk is the best nutrient for your baby and has many health benefits for both you and your baby. You should be very careful about what herbal and traditional medicines you use while breastfeeding, especially when your baby is a newborn, or if your baby was born prematurely.
Things to consider
There are concerns around the unregulated use of herbal and traditional medicines in breastfeeding.
All herbal and traditional medicines have the potential to pass into breast milk and affect your baby.
With most herbal and traditional medicines, there is not enough documented information to determine their safety in breastfeeding.
Some herbal and traditional medicines have not been scientifically proven to be effective.
Some herbal and traditional medicine products have not been regulated to ensure they are of good quality.
Common herbal and traditional medicines
Aloe vera gel is 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 orally in both the dried and liquid form. Avoid taking aloe vera latex as it has a strong laxative effect.
Black cohosh should be avoided because there is no information about the safety of using this product while breastfeeding. There is risk that it may reduce breast milk production because of the herbal medicine's hormonal effects.
Chamomile is considered safe to use in weak concentrations, such as in tea while breastfeeding.
Chamomile tea or tincture is also used to calm an upset stomach and help with sleeping problems. Chamomile can also be found in skin products to treat dermatitis, wounds and other skin conditions.
Cranberry may be used to prevent urinary tract infections in breastfeeding mothers. There is no information on the safety and efficacy of the medicine in breastfeeding, but is considered safe to use at the recommended doses.
Echinacea has been commonly used to treat or prevent upper respiratory tract infections. There is no information about the safety and efficacy of echinacea in breastfeeding. If you take echinacea while breastfeeding, watch for possible side effects in your baby, such as diarrhoea or constipation, poor feeding and skin rashes.
Evening primrose oil
There is limited information about the use of evening primrose oil in breastfeeding mothers. It is generally recognised as safe to use during breastfeeding at the recommended doses.
Traditionally, fenugreek is used to increase milk supply. The transfer of fenugreek into breast milk is unknown and unusual side effects such as allergy, colic, abdominal discomfort and diarrhoea have been reported in babies. Also, there is the potential for fenugreek to interact with other medicines.
Fish oil supplements are likely to be safe to use while breastfeeding at the recommended doses.
Flaxseed oil is generally safe and well tolerated. Supplementation of flaxseed oil seems to improve omega-3 fatty acid in the breast milk. It may be used by breastfeeding mothers at the recommended doses. Avoid large doses of flaxseed oil as it may increase the risk of side effects such as diarrhoea.
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. There is no information on the safety of garlic supplements in breastfeeding.
Ginger appears to be safe in amounts usually used in food preparation. Avoid using large amounts as there is not enough information available about the safety of ginger while breastfeeding.
Gingko should be avoided in breastfeeding women because there is very limited information about the use and safety of gingko products.
There is not a lot of information about the use and safety of ginseng in breastfeeding therefore it should be used with caution.
No information is available about the use of glucosamine in breastfeeding. It is unlikely that glucosamine will transfer into the breast milk and affect your baby.
Large amounts of liquorice or liquorice supplements should be avoided in breastfeeding mothers because there is limited safety information.
Lysine is considered safe to use by breastfeeding mothers at the recommended doses.
Avoid using milk thistle because there is no information on the safety of this traditional medicine when used by breastfeeding mothers.
When used as a tea, raspberry leaf is safe to use while breastfeeding. Raspberry leaf supplements should be avoided because there is limited safety information.
Spirulina should be avoided in breastfeeding women because there is very limited safety information. The spirulina product information indicates that it is suitable to take during breastfeeding, but consult your doctor or pharmacist before starting spirulina.
St John’s Wort
There is very little information available about the safety and efficacy 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.
There is very limited information about the use of valerian in breastfeeding. Avoid high doses of valerian as it may increase side effects such as drowsiness. An alternative should be considered especially when your baby is a newborn or was born prematurely. See your doctor or pharmacist for advice before starting valerian.
McGuire T, Walters J, Dean A, et al. Review of the Quality of Complementary Medicines Information Resources: Summary Report. In: Service NP, ed. Sydney; 2009.
The regulation of complementary medicines in Australia – an overview. 2012. (Accessed 29/06/12, 2012, at http://www.tga.gov.au/industry/cm-basics-regulation-overview.htm)
Loke Y, ed. Pregnancy and Breastfeeding Medicines Guide. 1st ed. Melbourne: The Royal Women’s Hospital, Pharmacy Department; 2010.
Hale TW. Medications and mothers’ milk. 14th ed ed. Texas: Hale Publishing; 2010.
Lactmed. In: Lactmed; 2012.
Australian Pharmaceutical Formulary and Handbook. 22 ed. Canberra: Pharmaceutical Society of Australia; 2012.
Braun L, Cohen M. Herbs and Natural Supplements. 3 ed; 2010.
Francois CA, Connor SL, Bolewicz LC, Connor WE. Supplementing lactating women with flaxseed oil does not increase docosahexaenoic acid in their milk. Am J Clin Nutr 2003;77:226–33.
Swiss Ultiboost Spirulina. 2012. (Accessed June 2012, at http://www.swisse.com/products/superfoods/ultiboost-spirulina)
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