The Basics

What is Borage / Borago officinalis?

Used for fever, cough, and depression.

Brand names for Borage / Borago officinalis

N/A

How Borage / Borago officinalis is classified

Complementary Therapies, Galactogogues, Phytotherapy, Plants, Medicinal

Borage / Borago officinalis During Pregnancy

Borage / Borago officinalis 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 Borage / Borago officinalis while pregnant

N/A

Taking Borage / Borago officinalis While Breastfeeding

What are recommendations for lactation if you're taking Borage / Borago officinalis?

Borage (Borago officinalis) is available as plant parts such as the leaf and flower and borage seed oil. Borage plant parts contain pyrrolizidine alkaloids that are toxic to the liver and lungs and possibly carcinogenic. These alkaloids might be excreted into breastmilk.[1] Borage plant parts have been used as a mild diuretic, expectorant, to induce sweating, and in proprietary mixtures promoted to increase milk supply;[2][3] however, no scientifically valid clinical trials support this use. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[4] Products containing other plant parts such as leaves should be avoided.[3] Borage seed oil contains high concentrations of gamma-linolenic acid, an omega-6 fatty acid, and possibly small amounts of pyrrolizidine alkaloids. Supplementation of nursing mothers with borage seed oil increases the breastmilk content of gamma-linolenic acid and dihomo-gamma-linoleic acid, but not arachidonic acid. Borage seed oil is generally well tolerated in adults; however, only products certified as pyrrolizidine alkaloid free should be used. Heating breastmilk to 63.5 degrees C reduces the concentration of linolenic acid by about 22%. Freezing milk at -20 degrees C and thawing more than once decreases linolenic acid concentration by an average of 63%.[5] 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

Borage (Borago officinalis) is available as plant parts such as the leaf and flower and borage seed oil. Borage plant parts contain pyrrolizidine alkaloids that are toxic to the liver and lungs and possibly carcinogenic. These alkaloids might be excreted into breastmilk.[1] Borage plant parts have been used as a mild diuretic, expectorant, to induce sweating, and in proprietary mixtures promoted to increase milk supply;[2][3] however, no scientifically valid clinical trials support this use. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[4] Products containing other plant parts such as leaves should be avoided.[3] Borage seed oil contains high concentrations of gamma-linolenic acid, an omega-6 fatty acid, and possibly small amounts of pyrrolizidine alkaloids. Supplementation of nursing mothers with borage seed oil increases the breastmilk content of gamma-linolenic acid and dihomo-gamma-linoleic acid, but not arachidonic acid. Borage seed oil is generally well tolerated in adults; however, only products certified as pyrrolizidine alkaloid free should be used. Heating breastmilk to 63.5 degrees C reduces the concentration of linolenic acid by about 22%. Freezing milk at -20 degrees C and thawing more than once decreases linolenic acid concentration by an average of 63%.[5] 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 Borage / Borago officinalis on milk supply

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

Possible alternatives to Borage / Borago officinalis

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. Panter KE, James LF. Natural plant toxicants in milk: a review. J Anim Sci. 1990;68:892-904. PMID: 2180885
2. Howard CR, Lawrence RA. Drugs and breastfeeding. Clin Perinatol. 1999;26:447-78. PMID: 10394496
3. Low Dog T. The use of botanicals during pregnancy and lactation. Altern Ther Health Med. 2009;15:54-8. PMID: 19161049
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. PMID: 29902083
5. Wardell JM, Hill CM, D’Souza SW. Effect of pasteurization and of freezing and thawing human milk on its triglyceride content. Acta Paediatr Scand. 1981;70:467-71. PMID: 7315290
6. Thijs C, Houwelingen A, Poorterman I et al. Essential fatty acids in breast milk of atopic mothers: comparison with non-atopic mothers, and effect of borage oil supplementation. Eur J Clin Nutr. 2000;54:234-8. PMID: 10713746

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.

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