Is Borage compatible with breastfeeding? Do we have alternatives for Borage?

Borage

February 1, 2017 (Low Risk)

Native plant from the Mediterranean region which is used as food.
For medicinal uses the inflorescences, leaves, stems and the oil of its seeds have been used.



The leaves contain traces of pyrrolizidine alkaloids that are known to be carcinogenic and hepatotoxic. The seed oil which is very rich in unsaturated fatty acids: gamma-linolenic (GLA), linoleic and oleic, is free of toxics alkaloids. Only products extracted from borage that are free of pyrrolizidine alkaloids should be consumed.



There is not enough evidence on the effectiveness of borage oil for topical treatment of eczema or arthritis (Cameron 2011, Bamford 2013).

Indication of borage by Commission E of the German Ministry of Health: none.



Mother’s diet supplementation with borage oil will increase GLA levels in breast milk (Thijs 2000). Preterm infants have been supplemented with borage oil as a source of GLA without side effects occurred (Demmelmair 2001, Fewtrell 2004).
A moderate and at short-term consumption of the oil is advised, since cases of severe intoxication have been reported. (Al-Khamees 2011).

Whenever used as food it is necessary be aware of it is a plant with a high content of nitrates with reported cases of methaemoglobinaemia in infants who were fed boiled mashed-borage, albeit this has not been described to occur through breastmilk (Martínez 2013).

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Beebread
  • Bee Plant

Writings

  • Borago officinalis (Latin, botanical name)

Drug trade names

References

  1. EMA - HMPC. Public statement on the use of herbal medicinal products containing toxic, unsaturated pyrrolizidine alkaloids (PAs). Committee on Herbal Medicinal Products (HMPC) 2014 Full text (link to original source) Full text (in our servers)
  2. Martinez A, Sanchez-Valverde F, Gil F, Clerigué N, Aznal E, Etayo V, Vitoria I, Oscoz M. Methemoglobinemia induced by vegetable intake in infants in northern Spain. J Pediatr Gastroenterol Nutr. 2013Abstract
  3. Bamford JT, Ray S, Musekiwa A, van Gool C, Humphreys R, Ernst E. Oral evening primrose oil and borage oil for eczema. Cochrane Database Syst Rev. 2013Abstract
  4. EMA-EFSA. Compendium of botanicals reported to contain naturally occuring substances of possible concern for human health when used in food and food supplements. European Food Safety Authority (EFSA). 2012Abstract Full text (link to original source) Full text (in our servers)
  5. Cameron M, Gagnier JJ, Chrubasik S. Herbal therapy for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2011Abstract
  6. Al-Khamees WA, Schwartz MD, Alrashdi S, Algren AD, Morgan BW. Status epilepticus associated with borage oil ingestion. J Med Toxicol. 2011Abstract Full text (link to original source)
  7. Fewtrell MS, Abbott RA, Kennedy K, Singhal A, Morley R, Caine E, Jamieson C, Cockburn F, Lucas A. Randomized, double-blind trial of long-chain polyunsaturated fatty acid supplementation with fish oil and borage oil in preterm infants. J Pediatr. 2004Abstract
  8. Demmelmair H, Feldl F, Horváth I, Niederland T, Ruszinkó V, Raederstorff D, De Min C, Muggli R, Koletzko B. Influence of formulas with borage oil or borage oil plus fish oil on the arachidonic acid status in premature infants. Lipids. 2001Abstract
  9. Thijs C, Houwelingen A, Poorterman I, Mordant A, van den Brandt P. Essential fatty acids in breast milk of atopic mothers: comparison with non-atopic mothers, and effect of borage oil supplementation. Eur J Clin Nutr. 2000Abstract