Is Cumin safe while breastfeeding?

Summary of use during breastfeeding

Cumin (Cuminum cyminum) seed contains a volatile oil that contains cuminaldehyde and other aldehydes; the seeds also contain numerous flavonoids and terpenes. Cumin has been used as a galactogogue in India, Pakistan and Türkiye with some literature support, including as part of an herbal mixture.[1-6] Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[7,8] No data exist on the excretion of any components of cumin into breastmilk or on the safety and efficacy of cumin in nursing mothers or infants. Cumin is "generally recognized as safe" (GRAS) as a spice and flavoring by the U.S. Food and Drug Administration. Cumin is generally well tolerated, but occasional phototoxic skin reactions have been reported after contact with the oil. Those allergic to cumin or related herbs should avoid cumin.

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

Women who were between 14 and 90 days postpartum and reported lactation failure were given instructions on breastfeeding technique and encouraged to exclusively breastfeed. If their infants had gained less than 15 grams in 1 week, they were randomized to receive either two tablespoonfuls of a mixture containing wild asparagus or an identical placebo for 4 weeks. In each 100 grams, the mixture contained Asparagus racemosus 15 grams, Anethum soiva 1 gram, Ipomea digitata 1 gram, Glycyrrhiza glabra 1 gram, Spinacia oleracea 2.5 grams, Cuminum cyminum 0.5 gram, and Panchatrinamol 1 gram. Of the 64 women randomized, 11 did not complete the trial. Serum prolactin measurements were made before a morning nursing before treatment, and after 4 weeks of treatment. Infant weight gains and the number of supplemental feedings were recorded initially and after 4 weeks of therapy. No differences were found in the changes in serum prolactin, infant weight gain or amount of supplementation between the treatment and placebo groups after 4 weeks of therapy. No side effects or changes in liver function tests occurred during the study.[11]

One hundred fifty-eight mothers in Iran of who reported difficulty in breastfeeding were given either a proprietary mixture of herbs (Shirafza Drop) or a chlorophyll solution as a placebo. The herbal mixture contained the purported galactogogues fennel, anise, cumin, black seed, and parsley. Infant ages ranged between 0 and 6 months and they were exclusively breastfed. Weight gain of the infants was measured over time. No difference in infant weight gain was seen between the two groups of infants.[12] Blinding and randomization in this study is unclear.

In an uncontrolled, non-blinded multicenter study in India, 1132 patients who reported inadequate milk supply were give a mixture (Lactancia, Corona Remedies Pvt. Ltd.) to take in a dose of 30 grams twice daily. The product contains Asparagus racemosus (wild asparagus, shatavari), Cuminum cyminum (cumin), Glycyrrhiza glabra (licorice), Spinacia oleracea (spinach) as well as amino acids, vitamins, minerals and DHA. Most of the mothers (1049) had improved lactation and increased infant weight.[13] However, with no placebo control group, results cannot be attributed to the product.

A blinded, triple-arm study compared the effects of cumin (Cuminum cyminum) drops, stinging nettle (Urtica dioica) drops, and placebo on several markers of lactation adequacy in healthy multiparous mothers with 10- to 15-day-old term infants. Fifteen drops of the preparations were given three times a day for 4 weeks. The method of preparation and content of the drops were not stated, but they were prepared especially for this study and not commercially available. The tastes and colors of the preparations may have compromised the blinding of the study; the placebo had no taste, but the taste and colors of the other preparations were not stated. At the end of the study, both the cumin and nettle groups had greater weight gains, higher feeding frequencies, more wet diapers, a higher weight of diapers, and more frequent defecation in the two treatment groups. Furthermore, these parameters were statistically greater in the cumin group than in the nettle group. No side effects were reported by the mothers.[14]

A commercial preparation containing wild asparagus 2 grams, dill 1.5 grams, cumin 1 gram, and cardamom 0.5 grams (Ayush-SS granules, Central Council for Research Ayurveda & Siddha, India) per dose was studied in a randomized double-blind trial in Indian mothers whose infants were experiencing “insufficient lactation”. This dose was given twice daily for 12 weeks beginning when full-term infants failed to regain their birth weight by 14 days postpartum, exhibited a weight gain of less than 20 grams daily between days 15 and 90 of life, or had fewer than six urinations per day. A per-protocol analysis (dropout rate 22%) found that at six months, 74 of 106 (70%) infants in the Ayush-SS group were exclusively breastfed, compared to 47 of 105 (45%) in the placebo group. After 90 days, 81 of 106 infants (77%) in the Ayush-SS group gained at least 20 grams per day compared to 44 of 105 (41.8%) in the placebo group. Maternal perceptions of insufficient lactation were lower in the Ayush-SS group (15% vs. 58%). All of these differences were statistically significant. No severe adverse events related to the intervention were observed.[5] The study was well designed and performed, but no intent-to-treat analysis was performed.

Levels in milk

Maternal Levels. Eighteen nursing mothers who were nursing their infants of 8 to 53 weeks of age were served a curry dish that contained an average of 1.06 mg of eugenol. The baseline eugenol concentration in milk was 1.11 mcg/L in one sample. Eugenol was found in concentrations of 1.63 mcg/L, 1.78 mcg/L and 2.92 mcg/L in the 1 hour, 2 hour and 3 hours samples from the same mother. Eugenol was below the limit of detection in all other samples.[9]

Twenty nursing mothers who were nursing their infants with a mean of 25 weeks of age were served a standardized curry dish that contained an average of 22 mg of cuminaldehyde, 1.1 mg of eugenol, and 35 mg of linalool. Mothers donated one milk sample each before and 1, 2, 3, 4, 5, 6, and 8 h after the eating the curry dish. Cuminaldehyde reached its maximum concentration in milk after 1 hour in two participants, after 2 hours in three participants, after 3 hours in two participants, after 4 hours in three participants and after 5 hours in three participants. In ten participants, cuminaldehyde was not detected in milk. Peak milk cuminaldehyde concentrations ranged from 0.74 to 61.87 mcg/L when it waws detected. Eugenol reached its maximum concentration in milk after 1 hour in two participants, after 2 hours in two participants, after 3 hours in three participants, after 4 hours in one participant after 5 hours in two participants, after 6 hours in three participants and after 8 hours in three participants. In seven participants, eugenol was not detected in milk. Peak milk eugenol concentrations ranged from 0.29 to 11.43 mcg/L. Eugenol concentrations averaged 200% higher after milk samples were treated with beta-glucuronidase, indicating transfer of conjugated eugenol into milk. Linalool reached its maximum concentration in milk after 1 hour in eleven participants, after 2 hours in six, after 3 hours in two participants, while in one participant, the maximum was not clearly determinable. Peak milk linalool concentrations ranged from 4.13 to 18.91 mcg/L. Linalool concentrations averaged 40% higher after milk samples were treated with beta-glucuronidase, indicating transfer of conjugated linalool into milk.[10]

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