The Basics
What is Blue Cohosh / Caulophyllum thalictroides?
Used for stimulating the uterus and starting labor; starting menstruation; stopping muscle spasms; as a laxative; and for treating colic, sore throat, cramps, hiccups, epilepsy, hysterics, inflammation of the uterus, pelvic inflammatory disease, and more.
Brand names for Blue Cohosh / Caulophyllum thalictroides
N/A
How Blue Cohosh / Caulophyllum thalictroides is classified
Complementary Therapies, Complementary Therapies
Blue Cohosh / Caulophyllum thalictroides During Pregnancy
Blue Cohosh / Caulophyllum thalictroides pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Blue Cohosh / Caulophyllum thalictroides while pregnant
N/A
Taking Blue Cohosh / Caulophyllum thalictroides While Breastfeeding
What are recommendations for lactation if you're taking Blue Cohosh / Caulophyllum thalictroides?
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][2][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.[2][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.
Maternal / infant drug levels
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][2][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.[2][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.
Possible effects of Blue Cohosh / Caulophyllum thalictroides on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Blue Cohosh / Caulophyllum thalictroides
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. 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. PMID: 10636495
2. Dennehy C, Tsourounis C, Bui L, King TL. The use of herbs by California midwives. J Obstet Gynecol Neonatal Nurs. 2010;39:684-93. PMID: 21044150
3. Low Dog T. The use of botanicals during pregnancy and lactation. Altern Ther Health Med. 2009;15:54-8. PMID: 19161049
4. Dugoua JJ, Perri D, Seely D, Mills E, Koren G. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15:e66-73. PMID: 18204101
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.