Hale seems to have always been extra cautious when it comes to herbals. I
don't think any are rated L1 or L2. One reason I heard him give is he feels
there is a problem with consistency of strength from source to source.
Aspirin is pretty much the same whether it is Bayer, St. Joseph's or a
generic off the shelf at Target. As I understand it, there can be much more
variability between blessed thistle (as an example) purchased at one store
and that purchased at another.
Look at his definition for L3-"There are no controlled studies in
breastfeeding women; however the risk of untoward effects to a breastfed
infant is possible or controlled studies show only minimal non-threatening
effects." To be classified as "L1" a drug needs to have been taken by large
numbers of bf moms without adverse effects and/or controlled studies fail to
demonstrate a risk and/or drug is not bioavailable to the infant. "L2"
means it has been used by a limited number with no adverse effects or
evidence of a demonstrated risk is remote.
Too often people especially those outside the bf support community seem to
think if a med isn't L1 it should be avoided. However L3 is defined as
"moderately safe" not "moderately dangerous"!
Winnie
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