I was delighted to see that Tom Hale rate St. John's wort (Hypericum
perforatum) as L2 in 2004 edition. This is quite the step for him to take as
evidenced by the detail of information he was careful to include in the
monograph, and the number of references he included to support it.

1. He had hoped for some lactation-specific work to be done on this herb,
and a couple studies have been recently published; one study showed no
adverse effects in 33 mothers-babies, another of one mom taking usual dose
showed milk levels of hypericin below level of detection and hyperforin
(another constituent of interest) in nanograms/mL with none detectable in
infant serum and no effect on baby, developmental or otherwise.

 Studies determining the serum concentration of constituents hypericin and
pseudohypericin had already been published (in nanograms/mL, pretty tiny)
[Hey: how much did anyone expect to find in milk or baby?].
Most other herbs are L3, same as many drugs. Sage is L4 (monograph needs
work)

2. Hale has has obviously compared the effects and especially the side
effects for St. John's wort and it's alternative pharmaceuticals.

Regards,
Sheila Humphrey
BSc RN IBCLC
The Nursing Mother's Herbal
PS milk thistle (Silybum marianum) has ethnobotanical evidence for use as
galactogogue, same as blessed thistle (Cnicus benedictus). Lots of thistles
around the world do.

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