Nutmeg use while Breastfeeding

Summary of Use during Lactation

Nutmeg (Myristica fragrans) seeds contain myristic acid, trymiristin, fatty acid glycerides and an essential oil, thought to be responsible for nutmeg intoxication, containing myristicin, elemicin, eugenol, safrole. Mace is a similar spice made from the dried covering of the nutmeg seed. Nutmeg has no specific lactation-related uses. No data exist on the safety and efficacy of nutmeg in nursing mothers or infants. Nutmeg, mace and their oils are "generally recognized as safe" (GRAS) as food ingredients by the U.S. Food and Drug Administration. High doses (e.g., a spoonful) of nutmeg can cause intoxication that includes anticholinergic symptoms. Anticholinergics may reduce lactation.[1,2] In vitro studies found that nutmeg may have antiprogesterone activity,[3] which also theoretically could affect lactation. Nutmeg and mace in amounts higher than those found in foods as a flavoring should be avoided during breastfeeding.

Dietary supplements do not require extensive pre-marketing approval from the U.S. 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 information about dietary supplements is available elsewhere on the LactMed Web site.

Drug Levels

Maternal Levels. Twenty nursing mothers who were nursing their infants with a mean of 25 weeks of age were served a standardized curry dish that contained an average of 1.1 mg of eugenol. Mothers donated one milk sample each before and 1, 2, 3, 4, 5, 6, and 8 h after the eating the curry dish. Eugenol reached its maximum concentration in milk after 1 hour in two participants, after 2 hours in two participants, after 3 hours in three participants, after 4 hours in one participant after 5 hours in two participants, after 6 hours in three participants and after 8 hours in three participants. In seven participants, eugenol was not detected in milk. Peak milk eugenol concentrations ranged from 0.29 to 11.43 mcg/L. Eugenol concentrations averaged 200% higher after milk samples were treated with beta-glucuronidase, indicating transfer of conjugated eugenol into milk.[4]

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.

Effects on Lactation and Breastmilk

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

References

1.

Bizzarro A, Iannucci F, Tolino A, et al. Inhibiting effect of atropine on prolactin blood levels after stimulation with TRH. Clin Exp Obstet Gynecol 1980;7:108-11. [PubMed: 6788407]

2.

Masala A, Alagna S, Devilla L, et al. Muscarinic receptor blockade by pirenzepine: Effect on prolactin secretion in man. J Endocrinol Invest 1982;5:53-5. [PubMed: 6808052]

3.

Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med 1998;217:369-78. [PubMed: 9492350]

4.

Debong MW, Homm I, Gigl M, et al. Curry-odorants and their metabolites transfer into human milk and urine. Mol Nutr Food Res 2024;68:e2300831. [PubMed: 38602198]

Substance Name

Nutmeg

Scientific Name

Myristica fragrans; Myristica officinalis

CAS Registry Number

84082-68-8

Drug Class

Breast Feeding

Lactation

Milk, Human

Complementary Therapies

Phytotherapy

Plants, Medicinal