Two different plant species with similar effects are known as chamomile: German chamomile (Matricaria recutita) and Roman chamomile (Chamaemelum nobile). Both contain similar ingredients, including sesquiterpenes (e.g., bisabolol, farnesene), sesquiterpenelactones (e.g., chamazulene, matricin), flavonoids (e.g., apigenin, luteolin), and volatile oils. Chamomile is used orally as a sedative and for gastrointestinal conditions; it is used topically for wound healing. Both herbal and homeopathic preparations have been used to treat mastitis and cracked, bleeding nipples.[1,2] Chamomile has been used as a galactogogue;[3,4] however, no scientifically valid clinical trials support this use. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[5,6]
Chamomile is "generally recognized as safe" (GRAS) for use in food by the U.S. Food and Drug Administration as a spice, seasoning, or flavoring agent. No data exist on the safety of chamomile in nursing mothers or infants, although rare sensitization may occur (see below).[7] It has been safely and effectively used alone and with other herbs in infants for the treatment of colic, diarrhea, and other conditions,[8-11] so the smaller amounts expected (but not demonstrated) in breastmilk are likely not to be harmful with usual maternal doses. Note that Clostridium botulinum (botulism) spores have been found in some loose-leaf chamomile teas sold in health food stores.
Topical chamomile is a known sensitizing agent, even with homeopathic products.[12] Two women developed contact dermatitis of the nipples and areolas after applying Kamillosan ointment for cracked nipples. The product was purchased in England and contained 10.5% Roman chamomile extracts and oil. Reactions were confirmed to be caused by Roman chamomile by patch testing in both women. Drinking chamomile tea can exacerbate topical skin rashes and has caused anaphylaxis in sensitized individuals.[13] Chamomile has possible cross-reactivity with other members of the aster family (e.g., echinacea, feverfew, and milk thistle).[7]
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.