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Blue Cohosh use while Breastfeeding

Medically reviewed by Last updated on Jun 26, 2022.

Blue Cohosh Levels and Effects while Breastfeeding

Summary of Use during Lactation

Blue cohosh (Caulophyllum thalictroides) root contains N-methylcytosine, which has nicotine-like effects, and caulosaponin, a glycoside that constricts coronary vessels and may have oxytocic activity. It has been used to promote labor.[1-3] Blue cohosh has no specific uses during breastfeeding. No data exist on the safety and efficacy of blue cohosh in nursing mothers or infants; however, it can cause severe gastrointestinal and cardiovascular toxicity, including in neonates whose mothers used it to stimulate labor. Most sources recommend strongly against its use during breastfeeding because of lack of safety data and potential toxicity.[3,4]

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

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

Effects on Lactation and Breastmilk

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


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]
Low Dog T. The use of botanicals during pregnancy and lactation. Altern Ther Health Med. 2009;15:54–8. [PubMed: 19161049]
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]
Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15:e66–73. [PubMed: 18204101]

Substance Identification

Substance Name

Blue Cohosh

Scientific Name

Caulophyllum thalictroides

CAS Registry Number


Drug Class

Breast Feeding


Complementary Therapies


Plants, Medicinal

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Further information

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