Is Vaccaria safe while breastfeeding?

Summary of use during breastfeeding

Vaccaria segetalis (cowherb seed) is a dry mature seed of Vaccaria hispanica seeds. The seeds are used in Chinese medicine (Wang Bu Liu Xing) to increase milk supply orally as a decoction.[1-4] The seeds contain quercetin and oleic acid as well as vaccarin. Vaccarin has a prolactin-like effect on the mammary epithelial cells and increase the number of prolactin receptors in animal studies.[4-6] Vaccaria seeds may also have mild estrogenic activity.[5] No well-performed clinical trials have been reported in English on the galactogogue effect of Vaccaria seeds taken orally in humans. It has reportedly been used frequently with Liquidambar formosana (Lu Lu Tong) as a galactogogue combination known as Wang Bu Liu Xing and Lu Lu Tong herb pair (WLHP).[4]

Vaccaria seeds are also topically applied with pressure to the earlobes in auricular therapy. Auricular therapy uses stimulation of acupoints on the ear corresponding to various anatomical sites and functions of the body for the diagnosis, treatment, and prevention of disease (see Acupuncture). Many studies applied Vaccaria seeds to press on ear acupoints. Two systematic reviews on auricular therapy to increase milk supply have come to differing conclusions. One review found a positive effect on milk production, onset of lactation, serum prolactin, breast fullness, neonate states, and frequency of newborn urination and defecation.[7] A more recent review found varying efficacy between studies and poor methodology that did not allow for a definitive conclusion on efficacy as a galactogogue.[8] No adverse effects were reported in any studies.

Effects on the breastfed infant

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

Effects on milk supply

In a randomized, nonblinded study of mothers who delivered a healthy infant at 37 weeks or beyond and expressed a desire to breastfeed, the Chinese herbal mixture Zengru Gao (n = 294) was compared to blank placebo (n = 294). Zengru Gao is composed of 8 herbs: Vaccaria seed, Medulla Tetrapanacis, Rehmanniae root, Angelica sinensis root, Paeoniae alba root, Ligusticum chuanxiong, Herba Leonuri (Motherwort Herb), and Trichosanthis root. The dose of Zengru Gao was 30 grams three times daily. On days 3 and 7, the group receiving Zengru Gao had more full and partial breastfeeding than those in the placebo group. In Zengru Gao group, 4 newborns had diarrhea, 3 newborns of allergies, 4 women of cough, 2 case of upper respiratory tract infections, 1 case of dry pharynx, and 1 case of neonatal hyperbilirubinemia. No complications were seen in the control group.[9]

A nonrandomized, nonblinded study of women who had undergone cesarean section compared those who received acupoint stimulation, breast massage and Vaccaria seed decoction twice daily for 7 days (n = 74) to those who received routine western medicine nursing intervention (instructing mothers to breastfeed, letting the baby contact and suck early after delivery, dietary guidance and psychological intervention, and instructing mothers to get more exercise). Serum prolactin was greater at 3 days postpartum in the acupoint group than the prenatal prolactin and at 1 day postpartum and in the control group. The acupoint group had a higher exclusive breastfeeding rate, higher milk yield at 48 hours postpartum, and milder breast tenderness than the control group. At 42 days postpartum the acupoint group had a greater infant weight than the control group.[10]

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.[11]

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.