Echinacea when breastfeeding

Diet and medication while breastfeeding

Breastfeeding mothers often worry that what they consume could affect their baby. You don't need to follow a special diet, but be aware that small amounts of some things you eat or drink could enter your breast milk or interfere with breastfeeding.

What you consume can enter your breast milk

Almost any chemical present in your blood will transfer into your breast milk. This usually happens in very small amounts, but it could upset your baby’s tummy or make them unusually sleepy or irritable.

The effect on your baby will depend on their age and health, the type of substance, how much you take, and when you consume the substance.

If you’re unsure about consuming something while you’re breastfeeding, ask your doctor about it.

Diet and breastfeeding

Regardless of which foods you eat, your body will make healthy breast milk. Eating a nutritious diet and drinking enough fluids will help you produce enough milk. Eating galactagogues (foods that are claimed to boost milk supply, such as fenugreek) may not work for many breastfeeding women.

Breastfeeding uses a lot of calories so you may need to eat a little more than normal. Make sure to include plenty of protein, calcium and iron in your diet. You may also need an iodine supplement.

Breastfeeding mothers often worry that some foods like spices, garlic, beans or cabbage might make their baby gassy and irritable. Food is rarely the cause, but if your baby seems particularly fussy every time you eat a certain food then avoid it. There is no need to avoid allergenic foods such as peanuts, egg or milk while you are breastfeeding.

Alcohol and breastfeeding

The amount of alcohol in your breast milk is the same as in your blood. Alcohol enters your breast milk 30 minutes to 1 hour after you start drinking. It takes about 2 hours for your body to get rid of the alcohol in each standard drink.

It’s best to limit alcohol while you’re breastfeeding. If you do have an occasional drink, feed your baby before you start drinking and express milk for the baby to have while there is still alcohol in your breast milk.

Use the Feed Safe app to calculate how much alcohol is in your breast milk and when it’s safe to feed your baby.

Medications and breastfeeding

Most medicines are safe to take while breastfeeding. Even if the medicine does pass into your breast milk, it’s usually in such a small amount that won’t harm your baby. However, ask your doctor or pharmacist for advice. Take special care if your baby was premature, is sick or on medication.

For more information on medicines that are safe to take while breastfeeding, call the NPS Medicines Line on 1300 633 424 (Monday to Friday, 9am to 5pm AEST).

Contraception and breastfeeding

Some contraception is safe while you are breastfeeding, although you may have to wait until a few weeks after the birth. Recommended forms of contraception for breastfeeding women are:

the contraceptive implant (sold as Implanon NXT®)
the intrauterine device (IUD)
contraceptive injection (sold as Depo-Provera®)
the mini pill
condoms
the diaphragm

Complementary and herbal preparations and breastfeeding

Complementary medicines include vitamins, herbal preparations, aromatherapy and homeopathic products. Like other medicines, complementary medicines can have side effects. Do not assume that complementary and herbal medicines are safe when you are breastfeeding as they may not have been tested properly. Some may have very little information about their safe use while breastfeeding.

Herbal preparations to avoid while you are breastfeeding include comfrey, coltsfoot, borage, aloe, black cohosh, feverfew, ginseng, licorice root and kavakava. Herbal products that are considered safe for breastfeeding mothers include chamomile, echinacea (used for a short time only), fennel, garlic, elderflower and ginger.

Talk to your doctor, pharmacist or call the NPS Medicines Line before you take any complementary medicine or herbal preparation while breastfeeding.

Smoking and breastfeeding

It is best not to smoke if you are breastfeeding. If you can’t quit, it is still better for your baby to breastfeed than not to breastfeed.

The amount of nicotine in your breast milk is halved about 1. 5 hours after each cigarette. So if you smoke, do so right after a breastfeed. The longer the time between a cigarette and the next feed, the better.

It is very important to protect your baby from passive smoking, or ‘second-hand smoke’, which puts your baby at risk of lung infections, asthma and Sudden Infant Death Syndrome. Don’t smoke around your baby, in the house or in the car.

Caffeine and breastfeeding

Caffeine can pass into your breast milk and make your baby restless. Try to limit foods and drinks containing caffeine such as coffee, tea, cola drinks and energy drinks. Newborn babies are particularly sensitive to caffeine.

The amount of caffeine in your breast milk usually peaks about 1 hour after you consume it. You should not have more than 300mg of caffeine per day while breastfeeding. The following is a handy guide:

mug of filter coffee: 140mg
single shot of espresso: 100mg
mug of instant coffee: 100mg
250ml can of energy drink: 80mg (larger cans may contain up to 160mg caffeine)
mug of tea: 75mg
cola drink (354ml): 40mg

Where to get more advice:

Pregnancy, Birth and Baby - 1800 882 436
Poisons Information Centre - 13 11 26
Australian Breastfeeding Association - 1800 686 268

Learn more here about the development and quality assurance of healthdirect content.

Is It Safe To Take Echinacea While Breastfeeding?

Taking echinacea during lactation is considered safe only when recommended by an expert.

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Echinacea is the name of a species of flowering plant belonging to the daisy group and is known to have medicinal value (1). If you plan to use Echinacea while breastfeeding, read the post for more information. The leaves and roots of the Echinacea plants are used for medicinal purposes. It is a common herbal ingredient in cold, flu, skin infections, and inflammation medicines. Read on for more information on Echinacea, its uses, benefits, safety during breastfeeding, and side effects.

Is It Safe To Have Echinacea While Breastfeeding?

There is little scientific data about the safety and efficacy of echinacea during lactation. Yet, its use under expert guidance in recommended doses is not considered harmful while nursing (2). There is limited evidence to suggest that compounds found in echinacea pass into breast milk.

Echinacea is available as herbal and traditional medicine products like herbal tea, juice, extracts, capsules, and tablets, and dietary supplements. If you want to use any of these echinacea preparations or products while nursing, then you should do so only after consultation with an expert in herbal medicine. They can guide you about the safe mode of use and appropriate dosage while nursing (3).

Does Echinacea Decrease Milk Supply?

There is no evidence to suggest that echinacea decreases breast milk production. If you are exploring herbal supplements, including echinacea, to manage (decrease or increase) breast milk production, then seek the advice of a complementary medicine expert.

Possible Uses Of Echinacea

Echinacea is often used for lactation-related issues, such as mastitis, in traditional medicine. Research shows that the ethanolic extract of echinacea contains alkamides, ketoalkenes, caffeic acid derivatives, polysaccharides, glycoproteins, and caftaric acid, which are responsible for its medicinal properties (1). These bioactive compounds exhibit immunomodulatory, antiviral, antioxidant, and anti-inflammatory properties (4). Confirming these claims needs more scientific research.

Echinacea is used in herbal treatment of the following conditions.

Infections: Traditional medicine supports the use of echinacea tincture or extract to treat upper respiratory infections, common cold, cough, and flu. Clinical research shows that Echinacea purpurea might reduce the duration and severity of symptoms when consumed at the first signs of a cold (5). However, more research is needed to establish appropriate use among nursing mothers.
Immune health: Numerous research studies show that Echinacea purpurea may help your immune system combat infections (6) (7). Even traditional medicine suggests using echinacea with a well-balanced diet to boost overall immunity. However, there are no conclusive studies on this effect.
Oxidative stress: Bioactive compounds in echinacea, such as cichoric acid and alkamides, exhibit antioxidant properties (3) (8). Reduced oxidative stress may be helpful for lactating mothers.
Anti-inflammatory functions: Some animal studies showed that the use of echinacea could help reduce excess inflammation (9). However, there are no studies to prove these effects in humans, especially in lactating women.
Skin issues: Some research studies show that echinacea possesses anti-inflammatory and anti-bacterial properties that could help suppress the growth of Propionibacterium, a common cause of acne (10). Echinacea purpurea cream and gel used in a study were found effective in improving skin hydration and reducing wrinkles (11).

The therapeutic effects of echinacea have been documented to be helpful in a few other health conditions, such as gingivitis, canker sores, cracked nipples, wound healing, and vaginitis (12).

Possible Side Effects Of Echinacea While Breastfeeding

Echinacea products are relatively well-tolerated. However, they may exhibit side effects in some cases. The oral or topical use of echinacea while breastfeeding may cause the following side effects (13).

Gastrointestinal issues, such as constipation and diarrhea
Skin rash
Allergic reactions, such as nausea, swelling, hives, and shortness of breath

These symptoms are majorly observed in the cases of a cross-reaction, especially with other flowers from the Asteraceae family (14). Thus, if you or your breastfeeding baby, are allergic to flowers, such as daisies, chrysanthemums, marigolds, and ragweed, then avoid using echinacea.

Echinacea while breastfeeding should be consumed under the guidance of an alternate medicine expert to treat lactation-related issues. This is prescribed for infections, inflammations, oxidative stress, and skin issues in alternative medicine. Echinacea is also used to boost immunity in herbal medicine. Although there is no evidence of echinacea decreasing breast milk production, you may take it after consulting with an expert, considering its effects, including allergies and gastrointestinal problems. Always ensure that the herbal medicines do not contain ingredients that may impact supplements or other medications and try to buy from trusted sources.

1. Azadeh Manayi et al., Echinacea purpurea: Pharmacology, phytochemistry and analysis methods; NCBI
2. Herbals and Breastfeeding; Pharmacistsmb.ca
3. Marwa Amer et al., Safety of Popular Herbal Supplements in Lactating Women; Reaserachgate
4. Aneta Lewicka et al., Supplementation of Plants with Immunomodulatory Properties during Pregnancy and Lactation—Maternal and Offspring Health Effects; NCBI
5. Richard Nahas and Agneta Balla; Complementary and alternative medicine for prevention and treatment of the common cold; NCBI
6. Zili Zhai et al., Enhancement of Innate and Adaptive Immune Functions by Multiple Echinacea Species; NCBI
7. Hyung-Ran Kim et al., Immune Enhancing Effects of Echinacea Purpurea Root Extract by Reducing Regulatory T Cell Number and Function; NCBI
8. Line Thygesen et al., Antioxidant activity of cichoric acid and alkamides from Echinacea purpurea, alone and in combination; Science Direct
9. Qian Liu et al., Chicoric Acid Supplementation Prevents Systemic Inflammation-Induced Memory Impairment and Amyloidogenesis via Inhibition of NF-κB; NCBI
10. M Sharma et al., The Potential Use of Echinacea in Acne: Control of Propionibacterium Acnes Growth and Inflammation; NCBI
11. S Yotsawimonwat et al., Skin Improvement and Stability of Echinacea Purpurea Dermatological Formulations; NCBI
12. Echinacea; Kaiserpermanente
13. Echinacea; Drugs and Lactation Database; NCBI
14. M.B. Fasano; Allergenic Cross-Reactivity between Echinacea and Ragweed; The Journal of Allergy And Clinical Immunology

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Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with over eight years of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children. Then she worked as a nutrition faculty and clinical nutrition coach in different... more

Charmaine Dominguez is a plant-based online dietitian nutritionist. She has her own online nutrition practice. Charmaine is currently living in LA, California in the US, and pursuing Masters of Public Health at California State University, Long Beach. She has completed her Bachelor in Nutrition and Dietetics at California State University, Long Beach. Charmaine is passionate about helping others regain control... more

Echinacea and breastfeeding. Can Echinacea be taken while breastfeeding?

Echinacea and breastfeeding. Can Echinacea be taken while breastfeeding? | E-lactation

Can Echinacea be taken while breastfeeding? What are the alternatives to Echinacea?

July 1, 2015 (Low risk)

A herb that is widely used even during pregnancy and breastfeeding. Due to the lack of toxicity with an appropriate dose and moderate consumption, it should be compatible with breastfeeding.

Roots and aerial tops are used. It contains polysaccharides, essential oil, flavonoids, pyrrolizidine alkaloids and others.

Unproven effects: immune stimulant, wound healing, anti-inflammatory.

Indications are: colds, bronchitis, skin lesions. Edges and air vertices are used.

It contains polysaccharides, essential oil, flavonoids, pyrrolizidine alkaloids . ..

Unproven effects: immune stimulant, wound healing, anti-inflammatory.

Indications according to Commission E of the German Ministry of Health: colds, bronchitis, skin lesions.

Unlike the European Scientific Collaboration for Phytotherapy (ESPC), the European Medicines Agency does not recommend use under 12 years of age (allergy risk). Avoid use for more than 8 weeks (risk of leukopenia)

Alternatives

We do not have alternatives to echinacea .

Very low risk

Breastfeeding compatible. Low risk for the baby.

Low risk

Moderately safe. Read the comment carefully.

High risk

Dangerous. Use a less risky alternative. Read the comment.

Very high risk

Very dangerous. High risk of stopping breastfeeding.

Synonyms

Black Sampson
Brauneria angustifolia
Coneflower
Amer MR, Cipriano GC, Venci JV, Gandhi MA. Safety of Popular Herbal Supplements in Lactating Women. J Hum Lact. 2015 Abstract
Kennedy DA, Lupattelli A, Koren G, Nordeng H. Herbal medicine use in pregnancy: results of a multinational study. BMC Complement Altern Med. 2013 Abstract Full text (link to source) Full text (link to our server)
The Royal Women’s Hospital Victoria Australia. Herbal and Traditional Medicines in Breasfeeding. Fact sheet. 2013 Full text (link to source) Full text (link to our server)
Sachs HC; committee on drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Abstract Full text (link to source) Full text (link to our server)
Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Abstract Full text (source link) Full text (link to our server)
Cuzzolin L, Francini-Pesenti F, Verlato G, Joppi M, Baldelli P, Benoni G. Use of herbal products among 392 Italian pregnant women: focus on pregnancy outcome. Pharmacoepidemiol Drug Saf. 2010 Abstract
Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis. 2007 Abstract
Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of echinacea (Echinacea angustafolia, e. purpurea and e. pallida) during pregnancy and lactation. Can J Clin Pharmacol. 2006 Abstract
Zaffani S, Cuzzolin L, Benoni G. Herbal products: behaviors and beliefs among Italian women. Pharmacoepidemiol Drug Saf. 2006 Abstract
Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Safe. 2005 Abstract
Nordeng H, Havnen GC. Use of herbal drugs in pregnancy: a survey among 400 Norwegian women. Pharmacoepidemiol Drug Saf. 2004 Abstract
Tesch BJ. Herbs commonly used by women: an evidence-based review. Am J Obstet Gynecol. 2003 Abstract
Einarson A, Lawrimore T, Brand P, Gallo M, Rotatone C, Koren G. Attitudes and practices of physicians and naturopaths towards herbal products, including use during pregnancy and lactation. Can J Clin Pharmacol. 2000 Abstract
Gallo M, Sarkar M, Au W, Pietrzak K, Comas B, Smith M, Jaeger TV, Einarson A, Koren G. Pregnancy outcome following gestational exposure to echinacea: a prospective controlled study. Arch Intern Med. 2000 Abstract
WHO. World Health Organization. Geneva. WHO monographs on selected medicinal plants. Volume I. WHO monographs 1999 Full text (link to source) Full text (link to our server)

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Moderate

Relatively safe. Mild adverse effects for the infant or lactation are possible. Particular attention to the dosage regimen and indications for use.

A herb that can be used even during pregnancy and lactation. Due to the absence of toxicity at the appropriate dosage and moderate consumption, the drug should be compatible with breastfeeding.
The European Medicines Agency does not recommend the use of the drug under 12 years of age (allergy risk). Use for longer than 8 weeks should be avoided (risk of leukopenia).
Echinacea species (Echinacea angustifolia, Echinacea purpurea, Echinacea pallida) contain high molecular weight polysaccharides (e. g. heteroxylan, arabinogalactan) and lower molecular weight compounds (e.g. alkylamides, caffeine conjugates such as chicoric acid and echinacosides) . Some products are standardized based on echinacoside and others based on chicory acid.
Excretion of some of the supposedly active alkamides was found in one mother's breast milk.
In general, echinacea is well tolerated in gastrointestinal disorders, diarrhea and constipation, skin rashes and generally allergic reactions.
Some sources indicate that echinacea is safe at recommended doses, while others recommend avoiding it during breastfeeding due to a lack of published safety data.

Sources

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We understand which active ingredient of the drug needs to be analyzed
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Evidence-based medicine is the most advanced method of clinical practice today, used in all developed countries.

A doctor who uses the principles of evidence-based medicine in everyday clinical practice, makes decisions based not on personal experience or the experience of colleagues, will prescribe to the patient only those drugs that have been tested by clinical trials, that is, their effectiveness has been proven.

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Questions and Answers

How is proven efficacy of a medicinal product determined?

According to the principles of evidence-based medicine, the drug is considered effective only in the presence of positive results of clinical studies with a high level of evidence. The effectiveness of a drug that has even a huge number of studies of a lower level cannot be considered proven.

How are high-quality clinical trials conducted for drugs?

In randomized controlled trials (RCTs), participants are randomly assigned to groups. Some patients fall into the experimental group, while others fall into the control group. Both groups are followed for a certain period of time and analyze the outcomes formulated at the beginning of the study. The effectiveness of treatment is evaluated in comparison with the control group.

An analysis of the combined results of several RCTs is called a meta-analysis. By increasing the sample size in a meta-analysis, more statistical power is provided, and, therefore, the accuracy of assessing the effect of the analyzed intervention.

What is the therapeutic efficacy of drugs?

It is worth separating the concepts of proven efficacy and therapeutic efficacy of drugs. Therapeutic efficacy is the ability to produce an effect (for example, lowering blood pressure), proven efficacy reliably confirms therapeutic efficacy. Thus, in theory, a drug may have therapeutic efficacy without having proven efficacy.

What are the criteria for assessing the proven efficacy of a drug in the MedIQ project?

We use the world's largest and most reliable databases of drugs and clinical trials as criteria for assessing proven efficacy. An example is the List of Essential Medicines of the World Health Organization. Any drug included in this list is vital for the treatment of various diseases, proven by numerous clinical studies.

If a drug has no studies, but it works for me, is it proven to work?

According to the principles of evidence-based medicine, a drug can be considered proven effective only if there are positive results from clinical studies of a high level of evidence. Your personal experience or the unconfirmed opinion of a doctor cannot be evidence.