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Are you considering St. John’s Wort {SJW} for postpartum depression?

Even though It’s become the most popular alternative to pharmaceuticals for depression in Europe and the US, it’s so much more than the “depression herb”. 

Let’s dive in.

Here’s my promise to you, by the end of this post you’ll understand the risk/benefit ratio and determine if SJW is right for you and the ONE person who should not take St. john’s wort.

St. John’s Wort can be useful for some types of depression, but it also has great benefits for anxiety, grief, melancholia, estrogen clearance, and numbness due to nerve pains and/or damage.

But, Is St. John’s Wort Safe While Breastfeeding?

Here are three References

#1 St. John’s Wort is considered a Level 2/3 by the German Commission E. in Dr. Aviva Romms Book; Botanical Medicine for Women’s Health¹.
  • What does that mean?
    • L2: Safer; Limited studies demonstrated, but no increased risk
    • L3: Moderately Safe; No controlled studies in breastfeeding women or controlled studies demonstrate minimal adverse effects
      • There are limited studies that show no increased risk in the child’s health.  Many studies have been flawed due to the poor use of extracts or questionable preparation of the product. 

:: In one study, women ingested 300 mg of St. John’s Wort a day and low levels of hyperforin were detected in breastmilk, however, no constitutes of the herbs was detectable in the babies plasma and no adverse effects were observed in either. Source

#2 Lactation and medication expert Thomas Hale & Hilary Rowe authors of Medications and Mothers milk suggest transfer to milk are minimal and it appears to be safe during lactation. ¹
  • However, 1 intact in each group was reported to be colicky, but there was no change in milk production and weight of the infants ¹
#3 The essential guide to herbal safety by Mills & Bones considers St. John’s Wort a Lactation Category CC. Compatible with breastfeeding, but use caution. ²
  • It appears the most common side effects would be colic, drowsiness, and lethargy giving the mother a signal to stop taking the botanical

And, keep in mind.. a small percentage of women have an increase in depression when they take St. John’s Wort.

So, if you notice any adverse effects, stop taking the supplement or tincture.

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St. John’s Wort Dosing

Personally, I prefer to take SJW as a tincture.

I like to test one herb at a time.  Then, when I feel comfortable, I like to use a combined tincture of SJW and nervines to soothe the nervous system.

  • Tincture Dosing: 40-60 drops; 3-4x day
  • Capsules: 300- 350mg of standardized extract 3x day {0-3% total hypericin}

St. John’s Wort Postpartum Benefits

Internally, you can take St. John’s Wort as a tincture or supplement for:

  • sciatica
  • as an antiviral to reduce cold symptoms
  • seasonal affective disorder (SAD)
  • menopause
  • Monthly PMS blues
  • mild/moderate depression
  • ** My favorite reason to take SJW is for detoxification to reduce excessive estrogen levels and to reduce PMS & PMDD

Externally, it has many benefits as well.

When you place the flowers St. John’s Wort in oil, it turns red.  Use this oil externally/topically for:

  • spinal/ nerve injuries due to childbirth
  • vulvodynia (vaginal pain)
  • also for first-degree burns, bruises, bites, and puncture wounds

Can you take St. John’s Wort for Postpartum depression?

Who should avoid St. John’s Wort?

SJW is well-known for enhancing liver detoxification, which reduces the blood flow of many medications.

  • Anyone taking the following medications should skip SJW for now
    • Avoid St. John’s Wort if you’re taking warfarin, digoxin, protease inhibitors, organ transplant antirejection drugs, or chemotherapy
    • Use caution with oral contraception
    • Use under a physicians supervision if you’re taking antidepressants
  • In large doses, you may notice photosensitivity to sunlight and want to avoid this
  • It’s also contraindicated during pregnancy, however, safety studies are lacking

In short…

St. john’s wort can be used during breastfeeding when you purchase a standardized product from a reputable company. Standardization of the herb is to guarantee that the consumer is getting a product in which the chemistry is consistent from batch to batch.

  • Look for 300 mg 3x day to decrease postpartum depression and watch for adverse effects like colic, lethargy, and an increase in depression in mom. 
  • Keep in mind, it takes a comprehensive approach to overcome postpartum depression and this is just one part of the puzzle.
  • Nervines are also needed to soothe the nervous system after childbirth.

Ashwagandha vs St. John’s Wort

Can’t decide where to begin? Watch this video.

 

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References:

References

¹ Romm, Aviva; Botanicals Medicine for Women’s Health pg 887 ²Mills & Bones: The Essential Guide to Herbal Safety Hale & Rowe; Medications & Mother’s Milk https://pubmed.ncbi.nlm.nih.gov/16566628/#:~:text=The%20only%20existing%20report%20on,John’s%20wort. https://kellymom.com/bf/can-i-breastfeed/meds/lactation_risk_cat/https://www.infantrisk.com/content/drug-entry-human-milk
St. John\'s Wort While Breastfeeding
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