CHICAGO (Reuters Health) - Breast-feeding moms who like to curl up with a cup of herbal tea may want to take a good hard look at the list of ingredients on their product of choice. Some herbs are perfectly fine for nursing moms, while others may be toxic or reduce milk supply, according to a pediatrician from Rochester, New York.
What's more, even herbs promoted as a natural way to boost milk production--such as those in mother's milk tea--may have hidden dangers, said Dr. Ruth Lawrence, of the University of Rochester, on Tuesday at the American Academy of Pediatrics meeting here.
The best bet may be to carefully scrutinize the product you use and keep in mind that the younger the infant--and the more milk they consume--the greater the potential risk, she said.
While an 18-month-old who nurses once a day may not be harmed by herbs in milk, an extremely premature infant breast-feeding exclusively may be more vulnerable. Overall, there is very little data available on how much of such compounds are passed on to the infant in milk, though more is known about the medicinal action on adults.
``Many people have abandoned coffee because they know something about the problems with caffeine, and have--without benefit of knowledge-gone to herbal teas, the constituents of which they know nothing,'' Lawrence said.
Certain herbal teas seem perfectly safe--including those containing evening primrose, mint, orange spice, rose hips and ginger, according to Lawrence. Rose hips contain vitamin C and ginger may calm motion sickness and fight nausea.
On the other hand, mother's milk tea contains a long list of herbs, some safe and some potentially toxic, Lawrence said. For instance, the tea contains fennel, which is a weak diuretic (a drug that promotes urine production) and borage, which is a pain reliever second only to the poppy, she said. The tea also contains comfrey leaf, which ``is probably the most dangerous,'' she said.
``In almost every other country in the world, comfrey root has been banned,'' she said. The herb can lead to potentially life-threatening liver disease and some children have died of liver failure after consuming comfrey root. The herb is sometimes recommended as a remedy for nipple soreness. A safer, proven option is lanolin, a compound derived from sheep's wool, Lawrence said.
Other herbs routinely recommended to breast-feeding moms as a way to promote milk production are problematic. Fenugreek is known to lower blood sugar and it clearly is passed on to the infant in breast milk, Lawrence pointed out.
While few studies have looked at fenugreek, a woman taking the herb begins to produce milk with a characteristic ``maple syrup'' odor, which the baby begins to emit as well. ``Some babies get very colicky and have loose stools and other problems,'' Lawrence said. Diabetic mothers may be at particular risk if they are taking other drugs to lower blood sugar, such as insulin.
``I think a mother should discuss it with her doctor and notify her pediatrician if she's having trouble with inadequate milk,'' Lawrence said. ``If she'd like to try fenugreek and the pediatrician has confirmed that she is doing everything right, and her breasts are performing okay, and she's using a good pump, then a little fenugreek would be fine.''
Other products appear to be safe, including lemon grass oil and oatmeal, although they have not been proven to actually increase milk supply.
Some cold remedies--such as echinacea tea--are not necessarily a good idea, especially if consumed on a routine basis. At least one nationally recognized brand adds in sage. ''The one herb we have associated with decreased milk supply is sage,'' she said. However, she noted that an occasional intake of sage--for example in dressing at Thanksgiving dinner--should not pose a problem. Other over-the-counter cold remedies are no better--decongestants can dry up the milk supply along with nasal passages.
Women suffering from postpartum depression may be tempted to take St. John's wort or other mood-altering herbs. The active ingredient in St. John's wort is hypericin, a serotonin reuptake inhibitor, or SSRI--a drug in the same class as Prozac or Zoloft. Women with a severe case of baby blues should be checked out by a doctor because they may be suffering from an underactive thyroid, Lawrence said. None of the SSRIs have been completely studied in breast-feeding mothers, but the benefits of the drugs may outweigh the risks for some women. In that case, St. John's wort may be fine, she said.
``We do need to treat these mothers,'' she said. Studies have shown that severe depression in a mother can have an impact on a baby's development.