Is Tang-Kuei Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Tang-Kuei? Is Tang-Kuei safe for nursing mother and child? Does Tang-Kuei extracts into breast milk? Does Tang-Kuei has any long term or short term side effects on infants? Can Tang-Kuei influence milk supply or can Tang-Kuei decrease milk supply in lactating mothers?

A herbaceous plant from the apiaceae family, originating in China. Its roots are widely used in traditional Chinese medicine, attributing to it numerous properties in relation to women (menstruation, menopause) and respiratory infections, none of which have been clearly scientifically proven (WHO 1999: p.25-34, EMA 2013).Not to be confused with angelica (Angelica archangelica, see specific information). Since the last update we have not found published data on its excretion in breast milk. It contains phytochemical components that can modulate the human oestrogen receptor (Powers 2015) and for some experts it should be avoided during breastfeeding (Amir 2011). It is a widely used plant (Hardy 2000, Zhu 1987), even during pregnancy and breastfeeding (Sim 2013). Given its lack of toxicity at the correct dosage (WHO 1999: p.25-34), moderate use during breastfeeding would have little or no risk. Precautions when taking plant preparations: 1. Ensure that they are from a reliable source: poisoning has occurred due to confusing one plant with another with toxic properties, as well as poisoning from heavy metals extracted from the ground and food poisoning due to contamination with bacteria or fungi. 2. Do not take in large amounts; follow recommendations from professional experts in phytotherapy. "Natural" products are not always good in any quantity: plants contain active substances from which much of our traditional pharmacopoeia has been obtained and can result in poisoning or act as endocrine disruptors if taken in excessive amounts or time periods.

Tang-Kuei (Angelica sinensis) root contains a number of chemicals, including ligustilide, ferulic acid, angelicide. Tang-Kuei has no generally recognized lactation-related uses, although some midwives in the United States reportedly have used it for postpartum blues or depression.[1] It is often used as part of a postpartum herbal mixture in Asia[2][3] and is used as a "women's herb" in Chinese medicine for symptoms associated with menstruation and menopause. No data exist on the excretion of any components of Tang-Kuei into breastmilk or on the safety and efficacy of Tang-Kuei in nursing mothers or infants. Although it is usually well tolerated in general use, it may increase the risk of bleeding in patients taking warfarin and antiplatelet drugs and cause photosensitivity reactions. Tang-Kuei is best avoided during breast feeding.[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 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 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.

A study in Japan compared the use of a mixture of 13 herbs, including Tang-Kuei, to ergonovine for their effects on lactation and serum prolactin in postpartum women. The herbal mixture, called Xiong-gui-tiao-xue-yin, was given in a randomized fashion to 41 women in a dose of 2 grams of a dried aqueous extract 3 times daily. A comparable group of 41 women were randomized to receive methylergonovine 0.375 mg daily. Therapy was started on the day of delivery, but the duration of therapy was not specified. Plasma oxytocin and prolactin were measured on days 1 and 6; milk volumes were measured daily, although the method of measuring milk volume was not specified. Serum prolactin was higher on days 1 and 6 in the women who received the herbals; plasma oxytocin was lower on day 1 in the women who received the herbal, but not different on day 6. Milk volumes were greater on days 4, 5, and 6 in women who received the herbal mixture.[5] This study has serious flaws that make its interpretation impossible. First, milk volume measurement is subject to considerable variability depending on the measurement method used, but the method was not specified. Second, methylergonovine has caused decreases in serum prolactin and milk production in some studies.[6][7] Because of the lack of a placebo group, the differences found could be a negative effect of methylergonovine rather than a positive effect of the herbal preparation. Because this study used a multi-ingredient combination products in which Tang-Kuei was only one component, the results might be different from studies in which Tang-Kuei was used alone.