| Herb Common Name/Rating * | Synonyms | Active Ingredient | Uses | Present in Milk | Safety/Efficacy |
|---|---|---|---|---|---|
| Aloe vera AAP – H L3 W – Asparagus | Aloe barbadensis , A. capensis, vera Wild asparagus root | Polysaccharide, glucomannan Asparagus racemosus | Wound healing and small burns | Unknown, probably none when applied to skin | Orally is a strong purgative; oral dosing not recommended during lactation. Dermal use ok. Nourishing herb; used in those debilitated or conv galactagogue (1 g powdered root per day in milk or juice). |
| Blessed thistle AAP – H L3 W – Borage AAP – H L5 W – Botulism AAP – H L3 W – | Borage officinalis Toxin | Many chemicals and volatile oils Pyrrolizidine alkaloid | Gastrointestinal symptoms Pain therapy | Unknown | This is not a galactagogue. It is a different plant from milk thistle. No known toxicity. Many uses. Contraindicated in pregnancy and lactation. In natural cases of botulism toxin does not get into the milk. Pharmaceutical product Botox treatment unlikely to reach milk. |
| Cannabis AAP 2 H L5 W – Capsaicin AAP – H L3 W – | Marijuana Capsicum | Δ9-Tetrahydrocannabinol (THC) Topical anesthesia | Sedative, hallucinogen | Yes Unknown | Remains in infant’s system for weeks, especially in fat. Available as a cream, lotion, or oral tablets. Used where vasodilation or warmth is needed. Can cause burning, stinging. Do not use on breasts. |
| Chamomile AAP – H L3 W – | Matricaria recutita, Aster Aceae family | Terpenoids (coumarins), flower heads | Antiinflammatory, carminative, antiseptic, sedative (all unproved) | Unknown | Potential for allergic reaction. Animal studies question safety in pregnancy and lactation. |
| Cohosh (black) AAP – H L4 W – | Cimicifuga racemosa, black cohosh, black snakeroot, found in Lydia Pinkham’s compound | Estrogenic compounds, tannins, terpenoids, use roots and rhizome | Dysmenorrheal, dyspepsia, rheumatism, menopause | Unknown | May cause hypotension; could decrease milk production? Efficacy and safety in lactation. |
| Cohosh (blue) AAP – H L5 W – | Caulophyllum, blue cohosh, squaw root | Roots and rhizome, methylcytosine, caulosaponin | Uterine stimulant, emmenagogue, increased blood pressure, like nicotine, induces labor | Safety of concern, can constrict coronary vessels; leaves and seeds are known to be toxic. Can induce labor. | |
| Comfrey FDA banned AAP – H L5 W – | Symphytum officinale | Roots and rhizome and leaves, allantoin, hepatotoxic, pyrrolizidine alkaloids | “Wonder drug,” heals wounds, used as poultice, used as tea | Yes | Venoocclusive disease causing hepatic failure. Banned in many countries; unsafe. |
| Echinacea AAP – H L3 W – | Echinacea angustifolia, coneflower | Whole plant, flowers, dried roots | Immunostimulant, antiinfective, tested for upper respiratory infections | Unknown | Has been studied; effective in short courses, not continual use. No known toxicity; probably safe during lactation. |
| Evening primrose AAP – H L3 W – | Oenothera biennis | Biennis, oil from seeds, cis-gamma-linoleic acid (GLA), a precursor of prostaglandin E 1 , essential fatty acids (EFA) | Lower cholesterol, lower blood pressure, lower dysmenorrhea, mastalgia, eczema | Yes | Efficacy: conflicting reports. Safety: +/− probably in small amounts. Supplements increase EFA in milk ; increase bleeding time. Do not use with phenol thiazines. |
| Fennel AAP – H L4 W – | Foeniculum vulgare | Dried ripe fruit, volatile oil, transanethole estrogenic effect | Carminative, loosen phlegm, galactagogue, increase libido | Probable | Volatile oil can be toxic; use only fruits (seeds). Because of estrogenic effect, its reputation as a galactagogue is questioned. |
| Fenugreek AAP – H L3 W – Feverfew Not rated | Trigonella foenumgraecum, Greek hayseed Chrysanthemum partenium Bachelor’s button | Dried ripe seeds, diosgenin, and alkaloids smell like maple syrup Leaves extract tincture | Hypoglycemia, galactagogue, anticoagulant, see text Associated with migraines. Menstrual irregularity antiinflammatory | Probable Unknown | Risk: cross allergy to chrysanthemum family. Probably in milk; infants smell of maple syrup. No studies of efficacy. Enhances effect of warfarin contraindicated during pregnancy. Value as galactagogue undocumented; decreases platelet aggregation. |
| Garlic (Supplement form) AAP – H L3 W – | Lily family: Allium sativum, poor man’s treacle, clove garlic, common garlic, allium, stinking rose | Alliin, ajoens | Has 125 different uses, some contradictory, both high and low blood pressure, antibacterial, antithrombotic, lower cholesterol | Yes | Can cause colic in breastfed infants. Can enhance warfarin. Not tolerated by some infants. |
| Galactagogues: increase milk supply Fenugreek (Greek hayseed) Goats rue (Galega officinalis) Alfalfa (member pea family) seeds can be toxic Borage contains amabilene/relieves pain can cause venoocclusive disease | Antigalactagogues: decrease milk supply. Fennel and estrogenic effects; oil is toxic. Peppermint, sage, parsley (tabbouleh salad) agnus castus (monk’s pepper) Jasmine flowers applied to breast | ||||
| Ginkgo AAP – H L3 W – | Ginkgo biloba | Flavones and glycosides, seeds, ginkgotoxin, ginkgo biloba extract (GBE), leaves for tea | Herbal antioxidant | Unknown | Placebo-controlled studies suggest no efficacy in young adults. Use in elderly more effective. Conflicting reports of safety. Not recommended in lactation. Enhances the effect of warfarin. Can cause bleeding even alone. |
| Ginseng AAP – H L3 W – | Panax ginseng ( P. quinquefolius ), Asian ginseng | Root and extracts | Panacea, cure-all, adaptogen, strengthening, increasing mental capacity | Unknown | Too much has been written, with considerable conflict of opinion. Ginseng abuse syndrome; research done mostly by manufacturers. Safety: not long-term use; efficacy questionable. Not recommended in lactation. Reduces effect of warfarin. |
| Grapefruit seed extract AAP – H – W – Grape seed AAP – H – W – | Flavonols Capsules, tablets (50-100 mg daily supplementation/150-300 mg daily therapeutic | Antimicrobial inhibits intestinal cytochrome 450 | Noted to have autoinfection, antiviral, antibacterial, and antifungal effects. Grapefruit is known to contain quinine, especially in the bitter skin and section fibers. Recommended as an extract for use by direct application on sore nipples. If it has antiinfectious properties, it should be effective when traumatized nipples have become infected. Antioxidant, anticancer agent for varicose veins, circulatory problems. May increase risk for bleeding. | ||
| Herbal teas | Tablets, powders, tea leaves | May include Gerry mander, comfrey, mistletoe, skull cap, pennyroyal, all of which are toxic. Always check constituents. | Many cause hepatotoxicity and/or venous occlusive disease. Many associated with hemorrhagic disease. | ||
| Kava AAP – H L5 W – Licorice root | Piper methysticum, Kew, tonga Glycyrrhiza glabra family | Roots/rhizomes, dihydropyrones with central nervous system activity, kavapyrones Glycyrrhizin acid rhizomes and roots | Inebriation, muscle relaxants, alternative to penzodiapams Laxative and cure for gastritis | Unknown Laxative, gastritis, hypokalemia | Unsafe in pregnancy and lactation. Numbs the mouth; nauseating. Causes yellow discoloration of the skin, hair, nails. Known for 4000 years; large doses: weakness, edema, weight loss, hypertension, hypokalemia, and confusion. Consumption should be avoided in pregnancy and lactation. |
| Milk thistle (holy thistle) (not blessed thistle) AAP – H L3 W – Raspberry root AAP – H – W – | Silybum marianum, St. Mary’s thistle Rubis idaeus leaves | Fruits, flavolignans, inhibits oxidative damage to cells Promote diverse urinary tract infections, morning sickness, ease labor | Protective effect, concentrates in the liver | Unknown | Galactagogue. Problem: can cause allergy; low oral bioavailability. Probably safe. Poor oral bioavailability. Safe in pregnancy and lactation. |
| Sage AAP – H L4 W – | Salvia officinalis | Fresh leaves and fresh flowering aerial parts, dried leaves, and oils prepared as extracts and teas | Loss of appetite, inflammation of mouth and pharynx, excessive perspiration | Unknown | Contraindicated in pregnancy. Suppresses lactation. Okay as a flavoring. |
| St. John’s wort AAP – H L2 W – Silymarin (micronized) AAP – H L3 W – | Hypericum perforatum Hyperforin Flavonolignans seeds Silybum marianum, Milk thistle, BIO-C | Naphthodianthrones, phloroglucinols Antioxidant Liver protectant possibly | Depression | Not detected Galactagogue | Can cause photosensitivity. Risk for self-medication for a serious psychiatric problem. Can reduce the effect of warfarin, induce cytochrome P-450 enzyme system. Dose variable in different products. Poorly soluble in water micronized for oral use as galactagogue. |
| Valerian root AAP – H L3 W – | Valeriana officinalis, all-heal, Amantilla, setwell, setewale, capon’s tail, heliotrope, vandal root | Liquid, tablets, tea, volatile oil | Nervousness and insomnia | Unknown | Not recommended in lactation. Used as a sedative, hypnotic. |
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