Elderberry and Breastfeeding

Summary of use during lactation

Elderberry (Sambucus nigra) fruit contains flavonoids such as quercetin, and anthocyanidins. The bark, leaves and root contain sambunigrin, which is potentially toxic because it can release cyanide. Cooked berries do not carry this risk.[1] Elderberry is most often used for influenza and immune stimulation. It has been used as a galactogogue in Türkiye, but no scientifically valid clinical trials support this use.[2] No data exist on the excretion of any components of elderberry into breastmilk or on the safety and efficacy of elderberry in nursing mothers or infants. Elderberry preparations have rarely caused allergic reactions. No recommendations can be made on the use of medicinal doses of elderberry products during breastfeeding. Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.

Drug levels in milk and infant serum

No components of elderberry have been measured in milk after its ingestion, but some have been measured after the ingestion of other foods. Quercetin can be found in breastmilk of mothers with normal diets.[3] Maternal Levels. Milk samples from 17 nursing mothers on uncontrolled diets were taken at 1, 4 and 13 weeks postpartum at times between 10 am and 1 pm. Average quercetin levels in breastmilk were 48 nmol/L at week 1, 60 nmol/L at week 4 and 51 nmol/L at week 13. Because of the uncontrolled diet and varying sampling times, the range of values among individuals was large.[4] Quercetin was measured in the milk of 11 mothers after they received an onion soup that contained either 0.8 or 1 mg/kg of quercetin glucosides. A baseline milk sample was obtained after a 5-day low-quercetin diet, and 7 milk samples were obtained over the 48 hours following soup ingestion. Baseline total (from conjugated and unconjugated) quercetin in breastmilk averaged 45 nmol/L. An average peak milk quercetin level of 68 nmol/L was attained at an average of 11.9 hours after the soup meal. The average half-life of quercetin in breastmilk was 50.3 hours.[5] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

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

Effects on lactation and breastmilk

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

References

1. Vlachojannis JE, Cameron M, Chrubasik S. A systematic review on the sambuci fructus effect and efficacy profiles. Phytother Res 2010;24:1-8.19548290 PubMed
2. Erarslan ZB, Kültür S. Medicinal plants traditionally used to increase breast milk in Turkey: An ethnobotanical review. J Herbal Med 2024;44:100849. doi:10.1016/j.hermed.2024.100849
3. Williamson G, Clifford MN. A critical examination of human data for the biological activity of quercetin and its phase-2 conjugates. Crit Rev Food Sci Nutr 2025;65:1669-705.38189312 PubMed
4. Song BJ, Jouni ZE, Ferruzzi MG. Assessment of phytochemical content in human milk during different stages of lactation. Nutrition 2013;29:195-202.23237648 PubMed
5. Romaszko E, Wiczkowski W, Romaszko J, et al. Exposure of breastfed infants to quercetin after consumption of a single meal rich in quercetin by their mothers. Mol Nutr Food Res 2014;58:221-8.23963751 PubMed