Is Black Cohosh safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Black Cohosh. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Black cohosh (Cimicifuga racemosa, formerly Actaea racemosa) root was thought to have mild estrogenic activity based on its triterpene content, which is standardized based on 27-deoxyactein. However, recent studies have found no estrogenic activity.[1,2] It is primarily used for postmenopausal symptoms and has been used to promote labor.[3-8] Currently, it has no specific uses during breastfeeding, although historically it was supposedly used by native American women as a galactogogue.[9] No data exist on the safety and efficacy of black cohosh in nursing mothers or infants. In general, there is a low frequency of adverse reactions, but dizziness, nausea, headache, rash, vomiting, and rarely, hepatitis and allergic reactions have been reported.[3,10,11] Some sources recommend against its use during breastfeeding because of the lack of safety data and its potential estrogenic activity,[10] while others do not contraindicate its use.[9]
Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
“No published information” means the studies do not exist yet — not that Black Cohosh is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Black Cohosh” (LM872). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.