Summary of Use during Lactation

Lavender (Lavendula angustifolia) flowers, leaves and oil contain linaloyl acetate, linalool, perillyl alcohol, 1,8 cineole (eucalyptol), and at least 100 other known compounds. Lavender has no specific lactation-related uses. Lavender preparations have traditionally been used for anxiety, insomnia and other neurologic conditions, infections, pain and a variety of other conditions, often as aromatherapy. A meta-analysis of 3 randomized, controlled trials concluded that lavender in different formats (aromatherapy, cream, tea) had a positive effect improving sleep quality in postpartum mothers.[1] Lavender is "generally recognized as safe" (GRAS) as a food by the U.S. Food and Drug Administration. In general, lavender is well tolerated, but no data exist on the safety and efficacy of lavender in nursing mothers or infants. Lavender oil has estrogenic and antiandrogenic activity, so topical application around the breast should be avoided.

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. Twelve nursing mothers who were19 weeks to 19 months postpartum ingested 100 mg of 1,8 cineole (eucalyptol) in the form of delayed-release capsules (Soledum-Klosterfrau Vertriebs GmbH, Germany) that release the drug in the intestine. Then they pumped 1 to 4 milk samples at the time they perceived the smell of eucalyptus on their breath which had been previously shown to be approximately concurrent. A total of 21 milk samples were obtained. Odor was rated by a panel of 3 to 5 experts as either smelling like eucalyptus or not. Fourteen of the samples had a distinct eucalyptus-like odor. Chemical analysis of the positive odor tests found 1,8-cineole in concentrations from 70 to about 2090 mcg/kg of milk, most in the range of 100 to 500 mcg/kg of milk. Samples with negative odor tests contained concentrations in the range of 0.98 to about 20.23 mcg/kg of milk. In one woman who donated 3 samples, the highest concentration of 71 mcg/kg occurred at 1.5 hours after ingestion, with concentrations of 1 mcg/kg before ingestion and 15 mcg/kg at 9.5 hours after ingestion.[2]

Eight women had their milk analyzed for 1,8-cineole metabolites. Ten metabolites and several enantiomers of these metabolites were detected.[3,4]

Eighteen nursing mothers who were nursing their infants of 8 to 53 weeks of age were served a curry dish that contained an average of 34.6 mg of linalool. Baseline linalool concentrations in milk averaged 0.22 mcg/L (range 0 to 1.1 mcg/L). Milk samples contained linalool in concentrations of 0.12 to 15.24 mcg/L at 1 hour after eating, 0.03 to 6.44 mcg/L at 2 hours after eating and 0.01 to 3.73 mcg/L at 3 hours after eating. In the same study, the curry dish contained an average of 394 mcg of 1,8-cineole. Baseline 1,8-cineole concentrations in milk averaged 1.44 mcg/L (range 0.07 to 7.57 mcg/L). Milk samples contained 1,8-cineole in concentrations of 0.19 to 7.41 mcg/L at 1 hour after eating, 0.33 to 7.86 mcg/L at 2 hours after eating and 0.22 to 3.33 mcg/L at 3 hours after eating.[5]

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

Effects in Breastfed Infants

Nursing mothers who were participating in an experiment on the excretion of 1,8-cineole (eucalyptol) in breastmilk took a 100 mg capsule of 1,8-cineole orally. Although instructed not to, 12 mothers breastfed their infants during the experiment. Mothers reported that none of their infants refused their milk or breastfed less than usual. Two mothers felt that their infants were more agitated a few hours after breastfeeding. A third mother reported that the infant stopped nursing from time to time and "looked puzzled", but resumed nursing. Upon repeating the experiment 6 weeks later, the infant did not react in an unusual way during breastfeeding.[2]

Effects on Lactation and Breastmilk

Gynecomastia occurred in 3 prepubertal boys who were using grooming products containing lavender oil. The gynecomastia resolved after the products were discontinued. In vitro testing found that lavender oil possesses mild estrogenic and antiandrogenic activity.[6] The relevance of these finding has been questioned,[7,8] but no further testing has been reported to confirm or refute the findings as of the revision date.

References

1.

Seiiedi-Biarag L, Mirghafourvand M. The effect of lavender on mothers sleep quality in the postpartum period: A systematic review and meta-analysis. J Complement Integr Med 2022;20:513-20. [PubMed: 35080353]

2.

Kirsch F, Beauchamp J, Buettner A. Time-dependent aroma changes in breast milk after oral intake of a pharmacological preparation containing 1,8-cineole. Clin Nutr 2012;31:682-92. [PubMed: 22405404]

3.

Kirsch F, Buettner A. Characterisation of the metabolites of 1,8-cineole transferred into human milk: Concentrations and ratio of enantiomers. Metabolites 2013;3:47-71. [PMC free article: PMC3901259] [PubMed: 24957890]

4.

Kirsch F, Horst K, Rohrig W, et al. Tracing metabolite profiles in human milk: Studies on the odorant 1,8-cineole transferred into breast milk after oral intake. Metabolomics 2013;3:47-71. doi:10.1007/s11306-012-0466-9 [CrossRef]

5.

Debong MW, N'Diaye K, Owsienko D, et al. Dietary linalool is transferred into the milk of nursing mothers. Mol Nutr Food Res 2021;65:e2100507. [PubMed: 34658145]

6.

Henley DV, Lipson N, Korach KS, Bloch CA. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med 2007;356:479-85. [PubMed: 17267908]

7.

Kalyan S. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med 2007;356:2542; author reply 2543-4. [PubMed: 17575592]

8.

Kemper KJ, Romm AJ, Gardiner P. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med 2007;356:2541-2; author reply 2543-4. [PubMed: 17568039]

Substance Name

Lavender

Scientific Name

Lavendula angustifolia

CAS Registry Number

8000-28-0

Drug Class

Breast Feeding

Lactation

Milk, Human

Complementary Therapies

Food

Phytotherapy

Plants, Medicinal