Licorice root, derived from the plant Glycyrrhiza glabra, is a popular herbal remedy and flavoring agent. Due to its potent biological activity, its safety during breastfeeding warrants careful consideration. Health organizations generally advise against using whole licorice root therapeutically during lactation because of potential adverse effects on both the mother and the infant. The lack of extensive human studies on its transfer into breast milk further contributes to the cautious recommendation to avoid its use.
Key Components Driving Safety Concerns
The primary safety concern regarding licorice root is the triterpenoid compound glycyrrhizin (glycyrrhizic acid). This compound is responsible for the characteristic taste and many of the herb’s physiological effects. Once ingested, glycyrrhizin is metabolized into its active form, glycyrrhetinic acid. Glycyrrhetinic acid has a chemical structure similar to corticosteroids and exhibits mineralocorticoid activity, which can interfere with the body’s natural hormone and electrolyte balance. The concentration of this active compound varies substantially depending on the product form (tea, extract, or candy), complicating the definition of a safe dosage.
Potential Impact on the Breastfeeding Infant
A primary concern is the potential transfer of glycyrrhizin or its metabolite, glycyrrhetinic acid, into breast milk. While glycyrrhizin has been detected in the milk of women consuming licorice, the concentration of the more potent glycyrrhetinic acid is not widely measured in human studies. Due to the compound’s hormonal activity, even a small transferred amount could pose a risk to a developing infant. The most significant risk is potential electrolyte disturbances, mirroring adult effects, as glycyrrhetinic acid mimics aldosterone. This promotes sodium retention and potassium loss, which an infant’s immature kidneys may struggle to manage, potentially causing hypokalemia (low potassium) or hypernatremia (high sodium).
Effects on Maternal Health and Lactation
Therapeutic consumption of licorice root can trigger systemic changes mediated by the mineralocorticoid effects of glycyrrhetinic acid. This action can lead to elevated blood pressure (hypertension) and potassium loss, resulting in hypokalemia. Excessive consumption of full-spectrum licorice root is known to cause these disturbances, which may manifest as headaches, edema, or abnormal heart rhythms. Licorice root also carries a concern regarding its impact on milk supply, as evidence suggests it may reduce serum prolactin levels necessary for lactation. This anti-prolactin effect could potentially decrease milk production, and licorice can also interact with various medications, including diuretics and heart medications.
Understanding Different Forms and Safer Alternatives
Not all licorice products pose the same degree of risk, making the distinction between forms important. Whole licorice root and its extracts contain the full spectrum of compounds, including glycyrrhizin, while deglycyrrhizinated licorice (DGL) is a processed form where the majority of this compound has been removed. DGL is considered a safer option during lactation because the primary compound responsible for hormonal and electrolyte side effects is absent. Chronic use of any full-spectrum product should be avoided, though small, occasional amounts used for flavoring are unlikely to deliver a therapeutic dose. For common ailments, safer herbal alternatives exist, such as ginger and chamomile, and consulting a healthcare provider is the best course of action before introducing any supplement while nursing.