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Sunday, December 8, 2013
Herbs and Breastfeeding
What effect does thermogenic herbs have on a breastfed baby.
By "thermogenic herbs" I`m assuming you refer to those botanicals/herbs that allegedly increase metabolism, causing a "thermogenic" response that is supposed to burn fat rather than muscle. These products may contain a number of different botanicals/herbs, including some form of the stimulants ephedrine and caffeine. Botanicals/herbs generally are labeled as "dietary supplements"; however, many have medicinal effects. Frequently, thermogenic herb products include a notation on the label to speak with a health care provider before using the product when breastfeeding/nursing a baby. Good advice! Just as with medications, biochemicals in botanicals, or herbs, can enter breast milk. And as with medications, some are compatible with breastfeeding and some may have adverse effects on a baby. The effect of any botanical depends on whether the active agent or its metabolite is bio-available to the infant and how much is bio-available. The level of bio-availability depends on how much, if any, actually gets into a baby`s system and what effect(s) may occur with exposure. Without the actual names of the botanicals/herbs contained in the "dietary supplement," it is impossible to answer your question. I would recommend sharing the list of ingredients with your baby`s pediatric care provider. If a product contains ephedrine, be aware that pediatric concerns mentioned by Hale (1999) include infant "anorexia, irritability, crying, disturbed sleeping patterns, excitement." (In some states, thermogenic herbal "dietary supplements" must contain a warning that the ephedrine group alkaloids in the form of herbal extracts may cause serious adverse health effects.) Caffeine generally is considered compatible with breastfeeding, but the form it is in and the amount may affect compatibility and is the reason caffeine in breast milk occasionally is associated with infant "irritability and insomnia" (Hale, 1999). It is possible to diet while breastfeeding without taking a substance that may affect a baby. Diets that lead to gradual postpartum weight loss (approximately 4-4« lb or 2 kg/month) do not seem to interfere with milk production as long as a mother is well-nourished and her baby is "allowed" to decide how often she/he will breastfeed, which ensures that the baby takes in enough calories (Dewey, 1998). It`s a good idea for a new mother to postpone dieting until recovered from pregnancy and birth, and breastfeeding is well established. When postpartum weight loss is desired, it is recommended that a woman combine some type of aerobic exercise with dieting in order to achieve and maintain lean body mass. All the best to you and your baby! References: Dewey KG (1998). Effects of maternal caloric restriction and exercise during lactation. Journal of Nutrition, 128(2 Suppl), 386-389S. Hale, TW (1999). Medications and mothers` milk (8th ed.). Amarillo, TX: Pharmasoft Medical Publishing.
* Learn important new information concerning the FDA withdrawal of dietary supplements containing Ephedrine Alkaloids (Ephedra or Ma Huang)
Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati