Goldenseal and Breastfeeding

Summary of use during lactation

Goldenseal (Hydrastis canadensis) root contains berberine and other isoquinoline alkaloids. Goldenseal has traditionally been used as an anti-infective both systemically and topically, although high-quality studies of its efficacy and safety are lacking. It has also been used to mask illicit drugs in the urine, although it appears to be ineffective with modern laboratory methods. Goldenseal has been used topically by nursing mothers to treat sore nipples.[1] No data exist on the excretion of any components of goldenseal into breastmilk or on the safety and efficacy of goldenseal in nursing mothers. Berberine can displace bilirubin from serum albumin, causing concern about exposure of newborn infants, because bilirubin can build up in the infant's brain, causing brain damage.[2] However, the extent of berberine's passage from the mother to the infant is unknown. Most sources recommend avoiding exposure of neonates to goldenseal via breastfeeding or otherwise.[3-5] 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

Maternal Levels. Relevant published information was not found as of the revision date. 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. Fleiss P. Herbal remedies for the breastfeeding mother. Mothering 1988;Summer:68–71.
2. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201–8.8513024 PubMed
3. Amir LH, Pirotta MV, Raval M. Breastfeeding - Evidence based guidelines for the use of medicines. Aust Fam Physician 2011;40:684–90.21894275 PubMed
4. O'Hara M, Kiefer D, Farrell K, et al. A review of 12 commonly used medicinal herbs. Arch Fam Med 1998;7:523–36.9821826 PubMed
5. Yarnell E. Botanical medicine in pregnancy and lactation. Altern Complement Ther 1997;3 (April):93–100. doi:10.1089/act.1997.3.93