Is St. John's Wort safe for breastfeeding moms?

General information

St. John's Wort acts as a very weak antidepressant (SSRI) and has been shown
to be effective for treating mild forms of depression. There is no evidence that St. John’s Wort is effective for treating severe forms of depression. Toxicity is considered to be quite low and side effects include GI disturbances, headache, insomnia and (rarely) photosensitivity. Because St. John's Wort causes the liver to metabolize some types of drugs much faster, you should consult your health care provider or pharmacist before taking this herb to check for adverse drug-to-drug interactions. Some sources recommend that St. John's Wort should not be used during pregnancy due to its uterotonic effects.

Use during lactation

In a study of one nursing mother taking three tablets of St. John's Wort per day (Klier 2002), the levels of various components of the herb in breastmilk ranged from low to below the detection limits. No side effects were observed in the mother or infant.

Thomas Hale, RPh, PhD, author of Medications and Mothers' Milk, says that St. John's Wort appears to be relatively safe for nursing mothers, but recommends that caution be used. He suggests that other treatments (Zoloft, Paxil) are probably preferred.

Herbals and Breastfeeding (Nice 2000) says that no known contraindication to breastfeeding exists, but suggests that the nursling be monitored for potential side effects.

Ruth Lawrence, MD, in Herbs and Breastfeeding says that breastfeeding mothers should not take St. John’s Wort without consulting their physician first.

Herb expert Tieraona Low Dog, MD, in Herbal Medicine - An Evidence-Based Approach does not list breastfeeding as a contraindication to taking St. John's Wort.

A Review of 12 Commonly Used Medicinal Herbs (O'Hara 1998), does not warn against its use during lactation, but says that it should not be used during pregnancy (uterotonic) or with other psychoactive agents. St. John's Wort can cause photosensitivity, especially in fair-skinned persons taking large doses.

Additional information

St. John's Wort from "Using Antidepressants in Breastfeeding Mothers" @

Herbal Remedies for Postpartum Depression @

Postpartum depression @ includes non-medication and herbal methods of treating depression and lots of additional information and links on postpartum depression and its treatment.

Klier CM, Schafer MR, Schmid-Siegel B, Lenz G, Mannel M. St. John's wort (Hypericum perforatum)--is it safe during breastfeeding? Pharmacopsychiatry. 2002 Jan;35(1):29-30.

St. John's Wort Q&A at Dr. Thomas Hale's Lactation Pharmacology website

Mills E, Montori VM, Wu P, Gallicano K, Clarke M, Guyatt G. Interaction of St John's wort with conventional drugs: systematic review of clinical trials. BMJ 2004 July;329:27-30.

Frank Nice, DPA, CPHP, Raymond J. Coghlan, Pharm.D. and Brian T. Birmingham, Pharm.D. Herbals and Breastfeeding. U.S. Pharmacist: September 2000, Vol. 25:9

O'Hara M, Kiefer D, Farrell K, Kemper K. A review of 12 commonly used medicinal herbs. Arch Fam Med. 1998 Nov-Dec;7(6):523-36.

Herbs and Breastfeeding by Ruth A. Lawrence, MD

Herbal Medicine — An Evidence-Based Approach by Tieraona Low Dog, MD

St. John’s Wort (Hypericum perforatum) from Memorial Sloan-Kettering Cancer Center

FDA Public Health Advisory: Risk of Drug Interactions with St. John's Wort and Indinavire and Other Drugs

Disclaimer: Most herbal treatments have not been thoroughly researched, particularly in regard to lactation. Herbs are drugs, and some caution is necessary. I am presenting this data as is, without any warranty of any kind, express or implied, and am not liable for its accuracy nor for any loss or damage caused by a user's reliance on this information.

Page last modified: 03/03/2005
Written: 07/13/1998

Disclaimer: All material on this website is provided for educational purposes only, although every effort is made to provide accurate and up-to-date information. Unless otherwise noted, the articles at this website are not written by doctors or other health care professionals. If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation.

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