Is Blue 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 Blue Cohosh. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Blue cohosh (Caulophyllum thalictroides) root contains N-methylcytosine, which has nicotine-like effects, and caulosaponin, a glycoside that constricts coronary vessels and may have oxytocic activity. It has been used to promote labor.[1-3] Blue cohosh has no specific uses during breastfeeding. No data exist on the safety and efficacy of blue cohosh in nursing mothers or infants; however, it can cause severe gastrointestinal and cardiovascular toxicity, including in neonates whose mothers used it to stimulate labor. Most sources recommend strongly against its use during breastfeeding because of lack of safety data and potential toxicity.[3,4]
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 Blue 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 “Blue Cohosh” (LM871). 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.