Ashwagandha (Withania somnifera) is an herb traditionally used in Ayurvedic medicine, often called Indian ginseng or winter cherry. The plant’s roots contain bioactive compounds called withanolides, which are believed to be responsible for its effects. Ashwagandha has gained popularity as an adaptogen, a substance thought to help the body manage stress and promote balance. Because it is used for anxiety and stress, many nursing mothers consider using the herb postpartum. Before introducing any supplement while nursing, consult a qualified healthcare provider.
Current Safety Consensus and Research Gaps
The consensus among major health organizations is to advise caution or avoidance of Ashwagandha during breastfeeding. This recommendation stems from a significant research gap, as there is no published clinical data on the safety and efficacy of the herb in nursing mothers or infants. No scientific studies have tracked whether the active components of Ashwagandha are excreted into human breast milk or what effect they might have on a developing baby.
In the United States, Ashwagandha is classified as a dietary supplement, placing it under different regulatory standards than pharmaceutical medications. Herbal products do not undergo the rigorous testing and pre-market approval process required for prescription drugs to prove safety and effectiveness. Manufacturers are responsible for ensuring safety but do not need to prove it before marketing the product.
The lack of standardized testing leads groups like the National Institutes of Health (NIH) and the German Federal Institute for Risk Assessment (BfR) to recommend against its use while nursing. This caution is important when nursing a newborn or a preterm infant, whose metabolic systems are less developed and more vulnerable to transferred substances. Without high-quality evidence, the potential risk to the infant is considered too high by many experts.
The absence of clinical trials means practitioners cannot calculate a relative infant dose (RID), the standard measure used to estimate the amount of a drug transferred through breast milk. This uncertainty makes it impossible to definitively state a safe dosage while breastfeeding. Furthermore, the quality and purity of herbal supplements vary widely, with some products containing contaminants like heavy metals or pesticides, adding another layer of unknown risk.
Mechanisms of Action and Theoretical Infant Risks
Ashwagandha’s mechanism of action involves its adaptogenic properties, which help modulate the body’s stress response system. It influences the hypothalamus–pituitary–adrenal (HPA) axis, the system controlling the body’s reaction to stress. Studies show that Ashwagandha extracts may reduce levels of cortisol, the body’s main stress hormone, which accounts for its anti-anxiety effects.
The theoretical risks to a nursing infant relate to the herb’s known effects on the adult body, which could transfer through breast milk. One concern is the herb’s side effect of drowsiness or sedation in adults. If sedative compounds pass into the breast milk, they could cause lethargy, excessive sleepiness, or feeding difficulties in the baby. These effects could be pronounced in a small or premature infant.
Another concern involves the herb’s impact on the endocrine system, specifically the thyroid and adrenal glands. Ashwagandha has been shown to increase thyroid hormone levels (T4 and T3) and can lower thyroid-stimulating hormone (TSH). A developing infant’s endocrine system is highly sensitive, and hormonal alteration via breast milk could interfere with normal thyroid function necessary for brain development.
The bioactive withanolides are fat-soluble compounds, increasing the possibility they could pass into breast milk. Although rare, case reports link Ashwagandha consumption to liver injury in adults. The potential for liver toxicity is an adverse effect that has led some European regulatory bodies to issue warnings against the supplement.
Guidelines for Supplementation and Alternative Stress Relief
Any decision to use a supplement while breastfeeding should involve a discussion with a healthcare provider, such as a physician or an International Board Certified Lactation Consultant (IBCLC). These professionals can weigh the potential benefits against the unknown risks for your specific situation. If a supplement is introduced, monitor the infant closely for any changes, such as increased sleepiness, digestive issues, or unusual behavior.
Due to the safety uncertainties surrounding Ashwagandha, many safe non-herbal alternatives exist for managing postpartum stress and energy. Lifestyle modifications carry no risk of transfer to the infant. Implementing consistent sleep hygiene, even short, frequent naps, helps regulate mood and energy levels.
Regular physical activity, such as aerobic exercise or yoga, reduces anxiety and stress by lowering cortisol levels naturally. Mindfulness practices, including meditation and simple breathing techniques, can engage the parasympathetic nervous system for relaxation. Focusing on a nutrient-dense diet rich in Omega-3 fatty acids, fruits, and vegetables supports brain health and reduces anxiety symptoms. Magnesium supplementation, particularly magnesium glycinate, is another recommended option for promoting relaxation.