Summary of Use during Lactation

Marshmallow (Althaea officinalis) root contains polysaccharide mucilage composed L-rhamnose, D-galactose, D-galacturonic acid, and D-glucuronic acid. Topical marshmallow preparations have been advocated for treating sore, cracked nipples[1] and breast pain.[2] Orally, marshmallow is a purported galactogogue,[3] and is included in some proprietary mixtures promoted to increase milk supply; however, no scientifically valid clinical trials support this use. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[4,5] No data exist on the excretion of any components of marshmallow into breastmilk or on the safety and efficacy of marshmallow in nursing mothers or infants. Marshmallow is generally well tolerated in adults, with allergic reactions reported rarely. Marshmallow is "generally recognized as safe" (GRAS) in amounts found in foods by the U.S. Food and Drug Administration. Although no data exist on the safety of marshmallow root during breastfeeding, it is unlikely to be harmful to the breastfed infant.

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 small manufacturer-sponsored, double-blind, randomized study compared Mother's Milk tea (Traditional Medicinals, Sebastopol, CA) to lemon verbena tea in exclusively breastfeeding mothers with milk insufficiency. Each Mother's Milk tea bag contained an unspecified amount of marshmallow root as well as several other herbs. Mothers were instructed to drink 3 to 5 cups of tea daily. No differences were seen between groups in infant digestive, respiratory, dermatological, and other maternal-reported adverse events. No differences were seen in the growth parameters of the breastfed infants between the two groups.[6]

Effects on Lactation and Breastmilk

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

References

1.

Stapleton H. The use of herbal medicine in pregnancy and labour. Part II: Events after birth, including those affecting the health of babies. Complement Ther Nurs Midwifery. 1995;1:165–7. [PubMed: 9456733]

2.

Yarnell E. Botanical medicine in pregnancy and lactation. Altern Complement Ther. 1997;3(April):93–100.

3.

Scott CR, Jacobson H. A selection of international nutritional and herbal remedies for breastfeeding concerns. Midwifery Today Int Midwife. 2005;75:38–9. [PubMed: 16320878]

4.

Brodribb W. ABM Clinical Protocol #9. Use of galactogogues in initiating or augmenting maternal milk production, second revision 2018. Breastfeed Med. 2018;13:307–14. [PubMed: 29902083]

5.

Breastfeeding challenges: ACOG Committee Opinion, Number 820. Obstet Gynecol. 2021;137:e42–e53. [PubMed: 33481531]

6.

Wagner CL, Boan AD, Marzolf A, et al. The safety of Mother's Milk(R) Tea: Results of a randomized double-blind, controlled study in fully breastfeeding mothers and their infants. J Hum Lact. 2019;35:248–60. [PubMed: 30005170]

Substance Name

Marshmallow

Scientific Name

Althaea officinalis

CAS Registry Number

73049-65-7

Drug Class

Breast Feeding

Lactation

Complementary Therapies

Phytotherapy

Plants, Medicinal