St. John’s Wort and Breastfeeding

St Johns Wort flower

St. John’s wort is one of the best herbal remedies for mild to moderate depression. Many mothers with postpartum depression benefit from St. John’s wort. There is, however, conflicting information in general about the safety of herbs and breastfeeding, including St. John’s wort.

From what I can find, there are no large studies on the matter. However, there have been several small studies that are very supportive of St. John’s wort and breastfeeding.

One set of studies offers “no reports of any adverse effects on the nursing infant,” (1). While another study states “the need for larger safety data,” it also “suggests, with precautions, that standardized St. John’s wort extracts may prove a safe alternative to SSRIs for postpartum depression,” (2).

The dosage used in the study was 300 mg of standardized St. John’s wort. Most regular depression protocols for St. John’s wort recommend 300 mg three times per day.

Here are some tips if you are considering trying St. John’s wort.

  • Take a product that is standardized, preferably organic, and from an excellent company that is GMP certified.
  • If you are not breastfeeding, you can start with 300 mg dose once per day for a few days, then increase to two per day until you reach three 300 mg capsules per day. Some women take up to two weeks to notice a difference, but others feel a change immediately.
  • Master herbalist Susun Weed recommends using St. John’s wort tincture to minimize all potential side effects. This form of the herb also allows you to increase your dosage easily.
  • Though it is unlikely, if your baby gets unusual symptoms like becoming colicky or drowsy, then stop entirely. It may be that the herb increases the let down reflex of the breast milk, and the baby can have trouble adjusting. Alternatively, the baby may be particularly sensitive to the herb. Although babies go through lots of changes in their bodies all the time, it’s important to be safe.
  • When breastfeeding, it’s best to start any herbal supplement gradually. Find the lowest dose that you feel benefits from. Even a small dosage over months as a part of a larger regimen may be very beneficial to you.

I think St. John’s wort is a very important herb for alleviating the symptoms of depression, and specifically postpartum depression, but don’t rely on it alone.

It won’t restore the lost nutrients you may be needing, or heal any hormone imbalance issues. Nor will it address any feelings of isolation or stress you may be experiencing. Postpartum depression is complex and you, wonderful mom, deserve lots of support! Do consult your physician and a lactation consultant for more information.

Do NOT use St. John’s wort if you are currently taking prescription antidepressants, the birth control pill, or are sensitive to the sun. St. John’s wort is not recommended for severe depression.

If you feel like you are currently in crisis, it’s essential that you seek help from dedicated crisis support, your family, and your health care providers immediately. Please note that any information found on Mamashine.net is not meant to replace appropriate medical care. Postpartum depression can be life threatening. Please be responsible and use discernment when using this site and its resources. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.


References:

  1. Lee A, Minhas R, Matsuda N, et al. The safety of St. John’s wort during breastfeeding. J Clin Psychiatry 2003;64:966-8.
  2. Klier CM, Schafer MR, Schymid-Siegel B, et al. St. John’s wort (Hypercium perforatum): is it safe during breastfeeding? Pharmacopsychiatry 2002;35:
Mariana Kurko
Mari is a licensed practitioner of Chinese medicine, a singer/songwriter and the creator of Mamashine. She is also a survivor of postpartum depression. Mari lives with her energetic son, her husband and various animals in Austin, TX.
5 Comments

Saria

says:

I meant to say thanks not that.. 🙂

Mariana Kurko

says:

Hi Saria, glad to help. It’s confusing and a lot of information to sort through. There’s no absolute answer to herbs and breast feeding safety, but we can make informed decisions. I have a new course coming up soon that goes in depth on this topic. Thanks for visiting!

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