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Is It Safe To Take Elderberry Syrup While Pregnant? Breastfeeding? A Naturopathic Doctor Weighs In

in Breastfeeding, Herbs & Spices, Immune System, Infectious Disease, Pregnancy, Supplements

We love elderberries in the Dr. Green Mom community! Made from Sambucus nigra berries, our elderberry syrup is tasty, effective, and familiar. Most of us have counted on elderberry for years to get us through cold and flu season, daycare bugs, and everyday sniffles. Our kids take elderberry syrup without complaint and we like taking it too!

However, when we get pregnant, we reconsider everything we put into our bodies. We check and double-check to make sure that things are safe! 

Being extra cautious about herbal medicine safety in pregnancy and breastfeeding is smart!

But that’s where we run into a problem with elderberries. Out in the wild west of the internet, there is conflicting information about the safety of elderberries and it’s hard to know who to trust. 

My opinion is that elderberry syrup is safe to take in pregnancy and breastfeeding and I’m going to lay out the reasons why I think it is safe, and the reasons why some other professionals urge caution.

I Believe Elderberry Syrup Is Safe In Pregnancy and Breastfeeding And Here’s Why

  1. Herbalists who specialize in women’s health recommend Elderberry syrup for upper respiratory infections during pregnancy and breastfeeding. However, in the case of pregnancy, elderberry is considered better for treating than preventing an upper respiratory tract infection and should only be taken for 5-7 days.
  2. Most herbal medicine books that I own have extensive lists of herbs that are to be avoided in pregnancy and breastfeeding and none of them mention elderberry.
  3. My clinical and personal experience: I’ve taken elderberry syrup during both of my pregnancies as have many of my friends and patients. 
  4. No evidence of harm or negative case reports regarding elderberry in pregnancy or breastfeeding despite their use by many many women for generations.

Reasons For Caution With Elderberry Syrup During Pregnancy and BreastfeedingSafe to take Elderberry Syrup While Pregnant or Breastfeeding - Dr. Green Mom

 

  1. There aren’t any safety trials done on pregnant animals or humans. 
  2. Theoretical concerns about cyanide poisoning. 

Cyanide Poisoning!? Is That Possible!?

The reason that cyanide poisoning is mentioned as a possibility is that elderberries contain molecules called cyanogenic glycosides (CNG), which can release cyanide when they are broken down. 

Some parts of the plant contain more cyanogenic glycosides than others (for example green berries, stems, and bark contain more than ripe berries). Ripe berries contain relatively low amounts of cyanogenic glycosides. They are further reduced by processing. A 2021 paper that studied the amounts of cyanogenic glycosides in Elderberry concluded: “the types and levels of CNGs observed in [elderberry] are very low and pose no threat to consumers in the use of fresh or processed [elderberry] products.” The same study reviewed 30 years of case reports and didn’t find any reports of elderberries causing cyanide poisoning. 

Based on the latest research, the possibility of cyanide poisoning from elderberry syrup is almost nonexistent. Ways to further reduce the risk include using high-quality commercially prepared elderberry syrups and using them for no more than 5-7 days during pregnancy. 

Other Elderberry Safety Concerns

Elderberry may interact with some medications, especially immunosuppressants. It may also be a bad idea to take with some immune system disorders. Consult your doctor. 

Summary

The choice about what herbs to take during pregnancy and breastfeeding is a personal one and should be guided by a qualified professional who understands herbal medicine. 

You may feel comfortable with taking elderberry syrup during pregnancy and breastfeeding based on generations of knowledge and experience within herbal medicine and the absence of evidence of harms (Remember to take only for 5-7 days if pregnant).

You may feel uncomfortable with taking elderberry during pregnancy and breastfeeding based on the lack of experimental evidence proving its safety.

Regardless of your personal stance on elderberry syrup, there are many ways to support your immune system and overall health during pregnancy and lactation. Probiotics, prenatal vitamins, and medicinal mushrooms (found in our mother’s immunity formula) combined with a healthy lifestyle are all good, safe strategies for staying well during pregnancy and beyond! 

References:

8 Safe and Effective Herbal Antibiotic Alternatives – Aviva Romm MD

Herbs in Pregnancy: What’s Safe, What’s Not? – Aviva Romm MD 

Elderberry, Probiotics, and Other Natural Ways to Prevent the Flu – Aviva Romm MD 

Elderberry Clinical Guide 

Elderberry: Health Benefits, Side Effects, Uses, Dose & Precautions

Appenteng MK, Krueger R, Johnson MC, Ingold H, Bell R, Thomas AL, Greenlief CM. Cyanogenic Glycoside Analysis in American Elderberry. Molecules. 2021 Mar 4;26(5):1384. doi: 10.3390/molecules26051384. PMID: 33806603; PMCID: PMC7961730. 

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