Management of depression in breastfeeding mothers – Are St. John’s Wort and other complementary therapies safe?

· UKMi
  • Women who are breastfeeding should be advised not to self-medicate with herbal preparations or nutritional supplements for depression.
  • Some evidence exists to support the safe use of St John’s Wort during breastfeeding but further data are needed to confirm these preliminary findings. For the time being, it is recommended that St.John’s Wort is avoided in breastfeeding mothers.
  • Published experience of the use of complementary medicines in lactation is confined to St John’s Wort and this is very limited. Minor side effects – colic, drowsiness and lethargy – have been described in breastfed infants whose mothers were taking St. John’s Wort. Breastfed infants exposed to the active constituents of St John’s Wort via milk should be monitored for sedation, poor feeding or any other untoward effects.
  • Because of the lack of data to support safe use in lactation, tryptophan and SAMe are best avoided in breastfeeding mothers