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St. John's wort or hypericum is a herb commonly used from ancient times. Firm evidence is available on its effectiveness for treatment of depression ^{(Howland 2010)}, to the extent that it should be avoided a sudden stop of medication to prevent a rebound effect. It has been also topically used for the treatment of wounds, burns and eczema due to healing and antiseptical properties. Constituents are: Hypericin, Hyperforin and Quercetin. Antidepressant properties are attributed to Hypericin but mostly to Hyperforin. Quercetin is a flavonoid which is commonly found in many fruits and eatable vegetables.

Hyperforin is excreted into breast milk in nil or clinically non-significant amount ^{(Klier 2006 & 2002)}, with not side-effects reported among breastfed infants from treated mothers ^{(Klier 2006 & 2002}), except for isolated and dubious cases of somnolence and colicky pain with spontaneous resolution with no medical intervention being required. ^{(Lee 2003)}

Hypericin has not been detected in the breast milk ^{(Klier 2002)}. Quercetin levels found were as low as of few nanomols/L, and related to composition of fruits and vegetables of diet. ^{(Romaszko 2014, Song 2013)}

Plasma hypericin and hyperforin levels in these infants were undetectable or at the limit of detection. ^{(Klier 2006 y 2002)}

Hypericum does not affect milk production or prolactin levels. ^{(Canning 2010, Lee 2003)}

It is important to make sure that composition and amount of Hypericum contained in commercially available products is correct, do not take it without medical surveillance, avoid sudden stop and consider pharmacological interactions with many other medications. ^{(Tesch 2003, Wurglics 2001)}

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives may be preferable^{(Royal W 2013, Sachs 2013, Amir 2011, Dugoua 2006)}, especially during the neonatal period and in the event of prematurity.

Precautions when taking plant preparations ^{(Anderson 2017, Powers 2015, Posadzki 2013, Efferth 2011, Kopec 1999, Hsu 1995)}:

• Make sure they are from a reliable source: poisonings have occurred due to confusion of one plant with another with toxic properties ^{(Hsu 1995)}, poisonings due to containing heavy metals extracted from the soil, and food poisoning due to contamination with bacteria or fungi. ^{(Anderson 2017)}
• Do not take in excess; follow the recommendations of expert phytotherapy professionals. “Natural” products are not good in any quantity: plants contain active substances from which much of our traditional pharmacopoeia has been obtained and can cause poisoning or act as endocrine disruptors if consumed in quantity or for an exaggerated time because they contain phytoestrogens. ^{(Powers 2015, Zava 1998)}

 

See below the information of this related product:

• Maternal Depression (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)