Is Echinacea safe while breastfeeding?

Summary of use during breastfeeding

Echinacea species (Echinacea angustifolia, Echinacea purpurea, Echinacea pallida) contain high molecular weight polysaccharides (e.g., heteroxylan, arabinogalactan) and lower molecular weight compounds (e.g., alkylamides, caffeoyl conjugates such as cichoric acid and echinacosides), but no single chemical is known to be responsible for Echinacea's biological activity. Some products have been standardized based on echinacoside, and others on cichoric acid. Echinacea has no specific uses during breastfeeding, but is commonly used orally to treat or prevent upper respiratory infections. Excretion of some of the purportedly active alkamides was found in breastmilk in one mother. No data exist on the safety and efficacy of Echinacea in nursing mothers or infants. In general, Echinacea is well tolerated with gastrointestinal upset, diarrhea and constipation, skin rash and rarely allergic reactions reported. It may also alter the metabolism of some dugs metabolized by the P450 enzyme system. Some sources indicate that Echinacea is safe in recommended doses,[1] while others recommend avoiding it during breastfeeding because of the lack of published safety data. Echinacea has also been used topically to treat skin infections. A topical combination with Calendula (Calendit-E) was more effective than breastmilk in treating sore and cracked nipples in one study.[2-4]

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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. One woman was given 4 Echinacea Premium tablets (each containing the equivalent of 675 mg of Echinacea purpurea root and 600 mg of Echinacea angustifolia root made from the dried ethanolic extracts). The total dose of N-isobutyldodeca-2E,4E,8Z,10E/Z-tetraenamide alkamides was 13.1 mg. The alkamides were present in breastmilk between 1 and 4 hours after ingestion in concentrations similar to those reported in the blood with the same dose of the product.[5] Further details were not present in the abstract.

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