Is Codonopsis pilosula safe while breastfeeding?

Summary of use during breastfeeding

Codonopsis pilosula root (dangshen) is a traditional Chinese herbal medicine that is typically used as a tonic, adaptogen or immunity booster.[1] It has been used as part of a herbal galactogogue mixture.[2] Because it is used in mixtures, its contribution to any outcome cannot be assessed. Its safety in breastfeeding is unknown.

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

A randomized controlled study evaluated the efficacy of an herbal galactagogic decoction combined with auricular acupressure in improving lactation outcomes. The decoction was self-formulated consisting of Wang Bu Liu Xing (Vaccaria seeds) 10 grams, Glycyrrhiza glabra (licorice) 6 grams, Astragalus membranaceus 12 grams, Angelica sinensis (dong quai) 12 grams, Atractylodes macrocephala 10 grams, Tongzhi 30 grams, Codonopsis pilosula (dangshen) 12 grams, and Andrographis paniculata (green chiretta) 6 grams. One daily dose was decocted in water to yield approximately 200 mL of liquid, which was divided into 2 oral doses per day. Both groups were treated for 2 weeks. A total of 104 women with postpartum hypogalactia were randomly assigned to a control group (auricular acupressure alone, n = 52) or an intervention group (auricular acupressure plus herbal decoction, n = 52) for 2 weeks. Primary outcomes included milk production and formula supplementation, while secondary outcomes were serum hormone levels (estradiol, progesterone, and prolactin), symptom scores, psychological status, and clinical effectiveness. Compared with the control group, the intervention group demonstrated lower estradiol and progesterone levels, higher prolactin levels, increased milk production, and reduced formula supplementation.[2]

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.