use of medications during lactation, and author of Hale’s Medications and Mothers Milk, an essential reference manual for clinicians. The Infant Risk Center offers the most current, complete, and evidence-based information on the transmission of maternal drugs into human milk.
5 reasons why the Infant Risk Center categorizes elderberry syrup as L4: Potentially Hazardous
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1) It has not been studied in breastfeeding mothers. Ethical concerns abound when attempting to do true double blind scientific research on pregnant or breastfeeding women. This is one main reason for the lack of data on herbs in this population.
2) It is not regulated, and the components in commercial formulas are unknown. “Proprietary blends” contain undisclosed ingredients and may contain inconsistent levels of active ingredients. Breastfeeding mothers need to know exactly what they’re consuming.
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3) Some parts of the elderberry plant contain higher levels of toxic components. Elderberry’s exact nutritional composition varies with the variety of plant, the ripeness of the berries when harvested, environmental conditions, and climate. Therefore, products may contain varying levels of active ingredients, as well as other plant components besides the actual berries. These other parts of the plant -such as unripe berries, bark, leaves, and roots- contain lectins (causes stomach problems) and cyanogenic glycosides (can release cyanide, a poison). It is impossible to be sure what is contained in the formulation, and the bark, roots, leaves, and unripe berries can release a significant amount of cyanide. While this is not considered a problem for adults in small to moderate quantities, it may be toxic to babies if transferred through breast milk.
4) It is unknown whether heat kills off enough of the toxic parts to be safe for breastfeeding. All elderberry needs to be cooked prior to consumption, and most of the toxic substances found in the berries are safely removed by cooking. This is not the case for stray bark or leaves that may get into the mixture in commercial preparations. Again, breastfeeding mothers need to know exactly what they are consuming.
5) Some store bought syrups also contain other potentially troublesome ingredients. Many commonly sold brands contain potentially dangerous substances such as bryonia, which has serious safety concerns even in small amounts, and is completely untested in breastfeeding mothers.
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