Is Coleus safe while breastfeeding?

Summary of use during breastfeeding

Coleus amboinicus (Plectranthus amboinicus) leaves are a traditional galactogogue used in Indonesia called torbangun or bangun-bangun in the local languages.[1] Human studies of poor quality indicate that it might have some efficacy as a galactogogue, but the studies are inadequate to establish activity.[2-4] A meta-analysis of studies (many in Malaysian) found that torbangun supplementation may increase breastmilk volume, but its effect on infant weight gain remains uncertain.[5] Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[6,7] No data exist on the excretion of any components of Coleus amboinicus into breastmilk or on the safety and efficacy of Coleus amboinicus in nursing mothers or infants, although it has been used for hundreds of years in Indonesia with apparent safety. A related plant, Coleus forskohlii, is well tolerated as a supplement. One nursing mother using torbangun, fenugreek and goat’s rue as galactogogues developed slightly elevated liver transaminases that reversed when goat’s rue and torbangun were discontinued.[8]

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Effects on the breastfed infant

Relevant published information was not found as of the revision date.

Effects on milk supply

A study of 67 healthy women who delivered a fullterm infant and desired to breastfeed for at least 4 months compared torbangun (Coleus amboinicus), fenugreek, and a control product containing placental extract and vitamin B12 (Molocco+B12) for their effects on breastmilk volume. No mention was made of any breastfeeding support provided to the women. Participants were randomly assigned to receive one of the products for 30 days and followed for another 30 days. A soup was made from 150 grams of Coleus amboinicus leaves 6 days per week for 30 days, beginning on the second postpartum day, and it was consumed during the day. Infants were weighed before and after each nursing at 2-week intervals during the study to measure 24-hour milk volume. In the torbangun group, the milk volume on day 28 was statistically greater than on day 14. The increase in milk volume on day 28 was 33% in the torbangun group, compared to a decrease of 15% in the control group and a decrease of 14% in the fenugreek group. However, the baseline production in the torbangun group was 20 to 23% lower than in the other groups and there was no statistical difference in milk volume at any time compared to the initial volume of milk in the control group. Analysis of breastmilk found no decrease in nutritional quality of milk in the torbangun group.[9]

A nonrandomized, unblinded study in Indonesia gave some mothers Coleus amboinicus leaves as a soup and other mothers nothing for 7 days after delivery. Based on maternal surveys, those who ingested Coleus appeared to produce milk a few hours sooner than those who did not (average 2.37 vs 3 days) and supplement their infants less frequently.[4]

A nonblinded study in Indonesia randomized postpartum women with perceived low milk supply to either an herbal decoction containing 25 grams Sauropus androgynus (katuk) leaves, 10 grams Coleus amboinicus (torbangun) leaves and 5 grams papaya leaves (n = 60) or to 500 mg Sauropus androgynus extract (CV Al-Ghuroba, Indonesia; n = 60). Patients were to take the product and weigh their infant twice daily for 28 days. Maternal serum prolactin was measured on day 14 and 28. Breast milk volume and infant’s weight increased on days 14 and 28, and serum prolactin levels in decreased in both groups; however, the changes were not statistically significant. Mean infant weights increased, with no difference between the two treatments. Two mothers in the combination group and 3 in the extract group had increases in aspartate aminotransferase and/or alanine aminotransferase.[10]

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.