Borage

Drug Levels and Effects:




Summary of Use during Lactation:


Borage (Borago officinalis) is available as plant parts such as the leaf and flower and borage seed oil. Borage plant parts contain pyrrolizidinealkaloidsthat are toxic to the liver and lungs and possibly carcinogenic. Thesealkaloidsmight 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 pyrrolizidinealkaloids. 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 pyrrolizidinealkaloidfree should be used.

Dietary supplements do not require extensive pre-marketing approval from the US 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. More detailed informationabout dietary supplementsis available elsewhere on the LactMed Web site.


Drug Levels:


Maternal Levels.

Forty nursing mothers averaging 5 weeks postpartum were randomized to receive borage oil capsules containing either 230 or 460 mg of gamma-linolenic acid (GLA) daily in 4 divided doses for 1 week. Half of the women in each group were considered to be atopic and had lower initial levels of arachidonic acid (AA) and dihomo-gamma-linoleic acid (DGLA) in their breastmilk. In the low-dose group of atopic mothers, GLA levels increased from 0.11% by weight to 0.16%. In the high-dose group of atopic mothers, GLA levels increased from 0.09% to 0.18%. DGLA also increased from 0.41% to 0.53% in the low-dose group and from 0.36% to 0.51% in the high-dose group. AA levels were not affected by supplementation.[5]

Infant Levels.

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


Effects in Breastfed Infants:


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


Possible Effects on Lactation:


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


References:


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. The Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #9: use of galactogogues in initiating or augmenting the rate of maternal milk secretion (First revision January 2011). Breastfeed Med. 2011;6:41-9. PMID:21332371
5. 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



Substance Identification:




Substance Name:

Borage

Scientific Name:

Borago officinalis

CAS Registry Number:

84012-16-8

Drug Class:


  • Complementary Therapies

  • Galactogogues

  • Phytotherapy

  • Plants, Medicinal


  • Administrative Information:




    LactMed Record Number:


    880


    Last Revision Date:


    Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.