Summary of use during lactation
Carrots (Daucus carota) contain alpha- and beta-carotene. A poultice of raw carrots applied to the breast has been used to treat uncomplicated breast engorgement during breastfeeding;[1,2] however, evidence of efficacy is lacking because engorgement tends to improve over time regardless of treatment.[3] In Angola and Malawi, women are advised to drink carrot juice as a galactogogue.[4] No scientifically valid clinical trials support the use of carrots as a galactogogue. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[5,6] Carotenoids (beta-carotene, lutein, lycopene, zeaxanthin) and carrot flavor are transmitted into breastmilk. Carrot intake can improve maternal and breastmilk beta-carotene and vitamin A status,[7,8] but excessive maternal intake of carrots can lead to a harmless, reversible discoloration of the breastfed infant’s skin. Exposure to carrot flavor in breastmilk can improve the future acceptance of carrots by the infant. Carrots and the closely related wild carrots have been used as galactogogues, but valid scientific evidence for this use is lacking.[9]
Drug levels in milk and infant serum
Maternal Levels. Beta-carotene is a normal component of breastmilk and supplementation of nursing mothers with beta-carotene supplements increases the concentration in breastmilk.[10–13] However, beta-carotene from carrots and other vegetables are less bioavailable than from pharmaceutical supplements.[8] A sensory panel of at least 8 participants smelled the breastmilk of 5 mothers who had been given 500 mL of carrot juice. The consensus of a panel was that the odor of carrots was strongest 2 hours after ingesting the carrot juice. The mothers were presented with timed samples of their own breastmilk and judged that the taste of carrot was strongest at 3 hours after carrot juice ingestion.[14] Twelve women were given fresh carrot paste containing 15 mg of all-trans beta-carotene daily for 3 days. Milk samples were collected on 3 days at least 3 hours after the meal that contained beta-carotene. Milk beta-carotene levels increased by an average of about 80% over the 3-day period.[15] A study of 39 mothers of preterm infants (24 to 34 weeks gestation) provided 184 milk and 21 plasma samples weekly up to 6 weeks postpartum. Mean lutein, zeaxanthin, beta-carotene, and lycopene concentration decreased as lactation progressed, with the highest concentrations in colostrum. Lycopene (41%) and beta-carotene (36%) were the predominant carotenoids in colostrum and for up to 2 weeks postpartum. The proportion of lutein and zeaxanthin increased with lactation duration to account for 45% of the carotenoids in mature milk.[16] Infant Levels. In a study of 39 mothers and their preterm infants (24 to 34 weeks gestation), 21 blood samples were obtained from infants at 6 weeks of age. The carotenoid concentrations averaged as follows: lutein 76.2 mcg/l, beta-carotene 24.5 mcg/L, zeaxanthin 13.6 mcg/L and lycopene 11 mcg/L. No correlation was observed in carotenoid content between maternal milk and infant plasma at 6 weeks postpartum.[16]
Effects in breastfed infants
A nursing mother was eating 2 to 3 pounds of carrots a week as raw and cooked carrots. The mother’s skin was yellow in color, but her sclera were clear. At 2 months of age, her breastfed infant was diagnosed as having jaundice because of a yellow coloration of the skin. Breastfeeding was discontinued and the infant’s skin returned to a normal color. The mother continued her diet and examination of the maternal serum found elevated levels of beta-carotene which was probably the cause of her infant’s skin discoloration.[17] Nursing mothers ingested either 300 mL of carrot juice (n = 20) or water (n = 18) 2 to 3 hours before nursing daily for a week. Their infants were then evaluated for their acceptance of cereal prepared with either carrot juice or water. The infants who had been exposed to carrots in breastmilk consumed less flavored cereal relative to plain cereal than the control infants and they spent less time feeding. The authors interpreted these results to be a form of sensory-specific satiety in which the infants become less responsive to a flavor that they have been extensively exposed to in the very recent past.[14] Seventeen nursing mothers were given 300 mL of carrot juice or water for 4 days per week for 3 consecutive weeks during the first 2 months of lactation. Other study groups received carrot juice during the last trimester of pregnancy or water during pregnancy and breastfeeding as a placebo. At a mean of 5.6 months of age, the infants were evaluated twice, once with cereal prepared with carrot juice and once with cereal prepared with water. Infants whose mothers received carrot juice during lactation scored higher on measures of acceptance of carrot-flavored cereal and took in more cereal than those whose mothers received water, but the latter difference did not reach statistical significance. These effects were similar, but stronger among infants exposed prenatally.[18]
Effects on lactation and breastmilk
Relevant published information was not found as of the revision date.
Source: Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, NCBI Bookshelf. Check LactMed for the most recent revision.
Medical disclaimer: This page is for qualified healthcare professionals and is a decision-support aid only. It does not replace clinical judgement, local protocols or product information. Verify every dose and threshold before use. See the full Medical Disclaimer.