Is St. John´s Wort compatible with breastfeeding? Do we have alternatives for St. John´s Wort?

St. John´s Wort

October 28, 2014 (Very Low Risk)

Herb commonly used from ancient times. Firm evidence is available on its effectiveness for treatment of depression, to the extent that it should be avoided a sudden stop of medication to prevent a rebound effect.

It has been also topically used for the treatment of wounds, burns and eczema due to healing and antiseptical properties.

Constituents are: Hypericin, Hyperforin and Quercetin. Antidepressant properties are attributed to Hypericin but mostly to Hyperforin. Quercetin is a flavonoid which is commonly found in many fruits and eatable vegetables.

Hyperforin is excreted into breast milk in nil or clinically non-significant amount with not side-effects reported among breastfed infants from treated mothers, except for isolated and dubious cases of somnolence and colicky pain with spontaneous resolution with no medical intervention being required. Plasma levels in those infants were undetectable or close to the lower detectable point (0.1μg/L).

Hypericin has not been detected in the breast milk. Quercetin levels found were as low as of few nanomols/L., and related to composition of fruits and vegetables of diet.

It is most important to make sure that composition and amount of Hypericum contained in commercially available products is correct, do not take it without medical surveillance, avoid sudden stop and consider pharmacological interactions with many other medications.

Alternatives

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

  • Goatweed
  • Hypericum perforatum
  • Saint John´s Wort
  • Зверобой Продырявленный

Drug trade names

References

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