There is no clinical evidence showing elderberry is safe or unsafe during breastfeeding. No studies have tested whether elderberry’s active compounds pass into breast milk, and no data exist on its effects in nursing infants. The LactMed database, maintained by the National Institutes of Health, states plainly: “No recommendations can be made on the use of medicinal doses of elderberry products during breastfeeding.”
That’s not a ban, but it’s not a green light either. Here’s what we do know to help you weigh the decision.
Why There’s No Clear Answer Yet
Elderberry (the fruit of the Sambucus nigra plant) is classified as a dietary supplement, not a medication. Supplements don’t go through the same rigorous testing process that prescription drugs do, and studies on herbal products in breastfeeding mothers are rare because researchers are understandably cautious about enrolling this population in trials.
The result is a data gap. Nobody has measured how much of elderberry’s bioactive compounds end up in breast milk after a mother takes a supplement, and nobody has tracked outcomes in infants exposed through nursing. The NIH’s Drugs and Lactation Database, the go-to reference for healthcare providers evaluating medications and supplements during breastfeeding, lists no relevant published information on effects in breastfed infants.
What Elderberry Actually Does
Elderberry is primarily used to shorten colds and support immune function. In a randomized, placebo-controlled trial of air travelers, those who took elderberry extract experienced colds that lasted about 4.75 days on average, compared to 6.88 days in the placebo group. The elderberry group also had roughly half the total sick days. These are modest but real effects, which explains why elderberry products are popular during cold and flu season.
You may also see claims that elderberry boosts milk supply. It has been used traditionally as a galactogogue (a substance believed to increase milk production) in parts of Türkiye, but no scientifically valid clinical trials support that use.
Raw Elderberry and Toxicity Concerns
One risk that applies to everyone, not just breastfeeding mothers, involves how elderberry is prepared. The plant contains compounds called cyanogenic glycosides. These are harmless when intact, but plant enzymes can break them down and release hydrogen cyanide. The highest concentrations are found in the stems and unripe green berries.
In practice, the levels found in ripe American elderberries are very low and researchers have concluded they pose no threat to consumers using fresh or properly processed products. Cooking, boiling, and commercial processing all reduce the potential for cyanide release by inactivating the enzymes responsible. This is why commercially prepared elderberry syrups, lozenges, and capsules are considered safe for the general population. Eating raw elderberries or using uncooked preparations made from stems or green berries is a different story and should be avoided regardless of whether you’re breastfeeding.
Ingredients to Watch in Commercial Products
If you decide to take elderberry, the supplement itself is only part of the picture. Many elderberry syrups contain added honey, which is safe for adults but worth noting if you’re giving any directly to an infant under one year. Some products also contain high amounts of sugar or other herbal ingredients like echinacea or zinc, each with their own safety profiles during lactation. A product with elderberry as the sole active ingredient and minimal additives gives you the simplest risk assessment.
Because supplements aren’t regulated as tightly as pharmaceuticals, quality varies between brands. Third-party testing seals (like USP, NSF, or ConsumerLab) indicate the product has been independently verified for purity and accurate labeling.
Weighing the Decision
The honest summary is this: properly prepared elderberry products are widely used by adults with a good general safety record, but there is zero direct evidence about what happens when a breastfeeding mother takes them. That puts elderberry in the same category as many herbal supplements during lactation, where the absence of evidence isn’t evidence of harm, but it isn’t a guarantee of safety either.
Some mothers feel comfortable taking a commercially prepared elderberry product at standard doses for a short period, such as during a cold. Others prefer to avoid it entirely until more data exist. Your healthcare provider can help you weigh the potential immune benefit against the unknowns, especially if you’re nursing a premature infant or a baby with health complications, where even small uncertainties carry more weight.