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

Liquorice

March 2, 2016 (High Risk)

Root of leguminous herb is used.

Content: essential oil, flavonoids, tannins, saponins, hydroxi-coumarins....

Unproven effects: anti-ulcerative and expectorant.

Indication after Commission E of German Ministry of Health: gastritis, gastric ulcer, cough, bronchitis.

Because of mineralocorticoid effects, Pseudoaldosteronism, Hypokalemic palsy, Hypernatremia, Edema, Heart arrhythmias and Arterial Hypertension, a longstanding use or abuse of licorice may be a cause of severe health disorders.

May be a cause of abortion and premature labor if taken while pregnancy.

Since it has anti-prolactin and estrogenic effects, decrease of milk production can occur within the first weeks after birth. Reportedly, one case of hyperprolactinemia has occurred.

There is no proof on its galactagogue effect.

Glycyrrhizin is responsible of many effects of Licorice which is excreted in small amount into breast milk. Two infants younger than one months were severely intoxicated (lethargy) after their mothers had drunk an daily average of 2 liters of a beverage containing a mixture of Licorice, Fennel, Anise and Goat's rue. It was assumed to be related to anethol contained in the fennel and anise.

Alternatives

We do not have alternatives for Liquorice.

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

  • Gan Cao, Gancao
  • Glycyrrhetic Acid
  • Glycyrrhetinic Acid
  • glycyrrhizic acid
  • Glycyrrhizin
  • Licorice
  • Sweet root

Writings

  • Glycyrrhiza glabra (Latin, botanical name)
  • Glycyrrhiza inflata (Latin, botanical name)
  • Glycyrrhiza uralensis (Latin, botanical name)

Drug trade names

References

  1. Powers CN, Setzer WN. A molecular docking study of phytochemical estrogen mimics from dietary herbal supplements. In Silico Pharmacol. 2015Abstract Full text (link to original source) Full text (in our servers)
  2. Oztürk S, Karaman K, Cetin M, Erdem A. Polymorphic ventricular tachycardia (Torsades de pointes) due to licorice root tea. Turk Kardiyol Dern Ars. 2013Abstract
  3. Robles BJ, Sandoval AR, Dardon JD, Blas CA. Lethal liquorice lollies (liquorice abuse causing pseudohyperaldosteronism). BMJ Case Rep. 2013Abstract
  4. Panduranga P, Al-Rawahi N. Licorice-induced severe hypokalemia with recurrent torsade de pointes. Ann Noninvasive Electrocardiol. 2013Abstract
  5. The Royal Women’s Hospital Victoria Australia. Herbal and Traditional Medicines in Breasfeeding. Fact Sheet. 2013 Full text (link to original source) Full text (in our servers)
  6. Omar HR, Komarova I, El-Ghonemi M, Fathy A, Rashad R, Abdelmalak HD, Yerramadha MR, Ali Y, Helal E, Camporesi EM. Licorice abuse: time to send a warning message. Ther Adv Endocrinol Metab. 2012Abstract Full text (link to original source)
  7. EMEA. Glycyrrhiza glabra L. and/or Glycyrrhiza inflata Bat. and/or Glycyrrhiza uralensis Fisch., radix. Community herbal monograph. 2012 Full text (in our servers)
  8. Mannion C, Mansell D. Breastfeeding self-efficacy and the use of prescription medication: a pilot study. Obstet Gynecol Int. 2012Abstract Full text (link to original source) Full text (in our servers)
  9. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  10. Cuzzolin L, Francini-Pesenti F, Verlato G, Joppi M, Baldelli P, Benoni G. Use of herbal products among 392 Italian pregnant women: focus on pregnancy outcome. Pharmacoepidemiol Drug Saf. 2010Abstract
  11. WHO. World Health Organization. WHO monographs on medicinal plants commonly used in the Newly Independent States (NIS). WHO monographs. 2010 Full text (in our servers)
  12. Zhou S, Koh HL, Gao Y, Gong ZY, Lee EJ. Herbal bioactivation: the good, the bad and the ugly. Life Sci. 2004Abstract
  13. Strandberg TE, Andersson S, Järvenpää AL, McKeigue PM. Preterm birth and licorice consumption during pregnancy. Am J Epidemiol. 2002Abstract
  14. WHO. World Health Organization. Geneva. WHO monographs on selected medicinal plants. Volume I. WHO monographs 1999 Full text (link to original source) Full text (in our servers)
  15. Le Moli R, Endert E, Fliers E, Mulder T, Prummel MF, Romijn JA, Wiersinga WM. Establishment of reference values for endocrine tests. II: Hyperprolactinemia. Neth J Med. 1999Abstract
  16. Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med. 1998Abstract
  17. Rosti L, Nardini A, Bettinelli ME, Rosti D. Toxic effects of a herbal tea mixture in two newborns. Acta Paediatr. 1994Abstract
  18. Shimada K, Sakaguchi T, Sato Y, Moridaira H, Omata K. [Simultaneous determination of ephedrine and glycyrrhizin in human breast milk by high performance liquid chromatography]. Yakugaku Zasshi. 1984Abstract
  19. Wong HB. Effects of herbs and drugs during pregnancy and lactation. J Singapore Paediatr Soc. 1979Abstract
  20. Werner S, Brismar K, Olsson S. Hyperprolactinaemia and liquorice. Lancet. 1979Abstract