Arnica use while Breastfeeding

Summary of Use during Lactation

The flowers of various Arnica species contain flavonoid glycosides, terpinoids, amines, coumarins and volatile oils. The flowers are most commonly used to make homeopathic products that are used topically as an analgesic agent. Arnica in homeopathic preparations has been used to treat mastitis and breast pain.[1] It is also sometimes used to treat postpartum perineal pain.[2,3] No information is available on the excretion of Arnica components in breastmilk. Maternal use of Arnica tea probably caused hemolytic anemia in one breastfed infant. Arnica is "generally recognized as safe" (GRAS) as a food by the U.S. Food and Drug Administration, but is not allowed in food in Canada. Oral ingestion of botannical Arnica products should be avoided because of its many toxic components, but homeopathic products and topical application are usually safe during breastfeeding. Arnica should not be used on broken skin and may cause allergic skin reactions as well as cross reactions in those allergic to members of the Asteraceae or Compositae families of plants (e.g., chamomile, chrysanthemum, dandelion, marigold, sunflower).

Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

A 9-day-old breastfed (extent not stated) infant developed hemolytic anemia 48 hours after his mother had begun drinking tea made from Arnica flowers. The infant's total bilirubin was 41 mg/dL, with a direct bilirubin of 5 mg/dL and a hemoglobin of 5 grams/L. The infant was otherwise healthy with normal glucose-6-phosphate dehydrogenase (G6PD) status. After exchange transfusions and phototherapy, the infant's anemia corrected and bilirubin lowered to 9.9 mg/dL. The mother stopped drinking the tea and resumed breastfeeding with no further hemolysis.[4] The infant's hemolysis was probably caused by the Arnica tea.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

References

1.

Castro M. Homeopathy. A theoretical framework and clinical application. J Nurse Midwifery. 1999;44:280–90. [PubMed: 10380446]

2.

Allaire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy: A survey of North Carolina certified nurse-midwives. Obstet Gynecol. 2000;95:19–23. [PubMed: 10636495]

3.

Dennehy C, Tsourounis C, Bui L, et al. The use of herbs by California midwives. J Obstet Gynecol Neonatal Nurs. 2010;39:684–93. [PubMed: 21044150]

4.

Miller AD, Ly BT, Clark RF. Neonatal hemolysis associated with nursing mother ingestion of Arnica tea. Clin Toxicol (Phila) 2009;47:726. Abstract. doi: 10.1080/15563650903076924. [CrossRef]

Substance Name

Arnica

Scientific Name

Arnica chamissonis Arnica cordifolia Arnica fulgens Arnica latifolia Arnica montana Arnica sororia

CAS Registry Number

8057-65-6; 68990-11-4

Drug Class

Breast Feeding

Lactation

Complementary Therapies

Phytotherapy

Plants, Medicinal