Last update Oct. 23, 2022

Peppermint

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Mentha is a genus of herbaceous plants of the Lamiaceae family. There are several species with differences in composition and properties.

Mentha citrata or weed grass is a variety that grows in Chile and Argentina. Mentha x piperita or Mint is a hybrid plant of Mentha spicata (Spearmint) and Mentha aquatica (Water mint). Dried leaves, containing essential oil (very rich in menthol), menthone, monoterpenes like isomenthone or 1,8-cineole (eucalyptol) and flavonoids, are used. (Fitoterpia.net acces.02/2022, EMA 2020, Wu 2019, de Groot  2016, WHO 2010 & 2004)

Indications based on traditional use: orally as a spasmolytic in dyspepsia, irritable bowel and flatulence; Topical or inhalation application for relief of coughs, colds, aches and itching. (EMA 2020)

The main components of mint, menthol and 1-8-cineole are excreted in breast milk in minute amounts (Hausner 2008, Kirsch 2012) that do not cause problems or cause rejection in infants. (Kirsch 2013)

Plant widely used in many cultures, including during pregnancy and lactation as calming, relaxing or anti-emetic (Kaygusuz 2021, Eid 2020, Sim 2013, Kennedy 2013, Westfall 2004), but according to some authors it can cause a decrease in milk production, being traditionally used for weaning, although there is little evidence to support this clinical use. (Suzuki 2020, Eglash 2014, Sim 2013)

It is used, also without evidence, to relieve colic in infants.(Biagioli 2016, Alves 2012, Abdulrazzaq 2009, Crotteau 2006)

Since it is non toxic at appropriate dose and a tiny excretion into breast milk of active metabolite Menthol, a moderate consumption is believed compatible while breastfeeding. Culinary and flavoring uses are compatible with breastfeeding.

It has been used topically to treat nipple cracks and/or soreness with similar or greater efficacy to lanolin or breast milk (Bolourian 2020, Shanazi 2015, Akbari 2014, Sayyah 2007, Melli 2007), but other studies conclude that the application of nothing or breast milk is more effective than that of mint or lanolin (Gharakhani 2018, Dennis 2014). The passage to plasma by skin absorption is minimal. (Martin 2004)

Menthol is an ingredient in preparations used in respiratory tract disorders, although it is considered neither safe nor effective. Do not apply on the chest or in places where the infant can inhale it.

In case of use on the nipple, do it after feeding the baby and cleanse thoroughly the surface before the next one.

Overdosing of essential oil may be harmful. Do not expose infants to inhalation of products that contain Menthol (irritation of the air way)

Precautions when taking plant preparations (Anderson 2017, Powers 2015, Posadzki 2013, Efferth 2011, Kopec 1999, Hsu 1995):

  • Make sure they are from a reliable source: poisonings have occurred due to confusion of one plant with another with toxic properties (Hsu 1995), poisonings due to containing heavy metals extracted from the soil, and food poisoning due to contamination with bacteria or fungi. (Anderson 2017)
  • Do not take in excess; follow the recommendations of expert phytotherapy professionals. “Natural” products are not good in any quantity: plants contain active substances from which much of our traditional pharmacopoeia has been obtained and can cause poisoning or act as endocrine disruptors if consumed in quantity or for an exaggerated time because they contain phytoestrogens. (Powers 2015, Zava 1998)

See below the information of these related products:

  • Pennyroyal (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)
  • Spearmint (Safe product and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Tradenames

Main tradenames from several countries containing Peppermint in its composition:

Pharmacokinetics

Variable Value Unit
Theoretical Dose Menth: 0.0012 / 1.8 Cin: 0.075 mg/Kg/d
Relative Dose Menthol: 0.07 / 1.8 Cin: 4.5 %

References

  1. Fitoterapia.net. Vanaclocha B, Cañigueral S. Fitoterapia.net. 1992 - - Disponible en: https://www.fitoterapia.net. Consulted on Dec. 21, 2023 Abstract
  2. Kaygusuz M, Gümüştakım RŞ, Kuş C, İpek S, Tok A. TCM use in pregnant women and nursing mothers: A study from Turkey. Complement Ther Clin Pract. 2021 Feb;42:101300. Abstract
  3. Suzuki N, Tsugami Y, Wakasa H, Suzuki T, Nishimura T, Kobayashi K. Menthol from Mentha piperita Suppresses the Milk Production of Lactating Mammary Epithelial Cells In Vivo and In Vitro. Mol Nutr Food Res. 2020 Nov 14:e2000853. Abstract
  4. Bolourian M, Dadgar H, Aqadousti R, FiroozBakht M, Khakpour M, Rokni A, Abdi F, Ramazanian Bafghi Z, Dabagh fekri S, Ghahremani S. The Effect of Peppermint on the Treatment of Nipple Fissure during Breastfeeding: A Systematic Review. International Journal of Pediatrics, 2020; 8(7): 11527-11535. doi: 10.22038/ijp.2020.46558.3784 Abstract Full text (link to original source) Full text (in our servers)
  5. Eid AM, Jaradat N. Public Knowledge, Attitude, and Practice on Herbal Remedies Used During Pregnancy and Lactation in West Bank Palestine. Front Pharmacol. 2020 Feb 14;11:46. Abstract Full text (link to original source)
  6. Wu Z, Tan B, Liu Y, Dunn J, Martorell Guerola P, Tortajada M, Cao Z, Ji P. Chemical Composition and Antioxidant Properties of Essential Oils from Peppermint, Native Spearmint and Scotch Spearmint. Molecules. 2019 Aug 2;24(15). pii: E2825. Abstract
  7. As'adi N, Kariman N. Herbal prevention and treatment of nipple trauma and/or pain in Iranian studies: A systematic review. J Herbmed Pharmacol. 2018;7:168–75. Abstract Full text (link to original source) Full text (in our servers)
  8. Gharakhani Bahar T, Oshvandi K, Zahra Masoumi S, Mohammadi Y, Moradkhani S, Firozian F. A Comparative Study of the Effects of Mint Tea Bag, Mint Cream, and Breast Milk on the Treatment of Cracked Nipple in the Lactation Period: A Randomized Clinical Trial Study. Iranian Journal of Neonatology IJN, 2018; 9(4): 72-79. doi: 10.22038/ijn.2018.30078.1409 Abstract Full text (link to original source) Full text (in our servers)
  9. Anderson PO. Herbal Use During Breastfeeding. Breastfeed Med. 2017 Abstract
  10. Biagioli E, Tarasco V, Lingua C, Moja L, Savino F. Pain-relieving agents for infantile colic. Cochrane Database Syst Rev. 2016 Sep 16;9:CD009999. Abstract
  11. de Groot AC, Schmidt E. Essential Oils, Part III: Chemical Composition. Dermatitis. 2016 Jul-Aug;27(4):161-9. Abstract
  12. Powers CN, Setzer WN. A molecular docking study of phytochemical estrogen mimics from dietary herbal supplements. In Silico Pharmacol. 2015 Mar 22;3:4. Abstract Full text (link to original source) Full text (in our servers)
  13. Shanazi M, Farshbaf Khalili A, Kamalifard M, Asghari Jafarabadi M, Masoudin K, Esmaeli F. Comparison of the Effects of Lanolin, Peppermint, and Dexpanthenol Creams on Treatment of Traumatic Nipples in Breastfeeding Mothers. J Caring Sci. 2015 Dec 1;4(4):297-307. Abstract Full text (link to original source) Full text (in our servers)
  14. Eglash A. Treatment of maternal hypergalactia. Breastfeed Med. 2014 Abstract Full text (link to original source) Full text (in our servers)
  15. Akbari SA, Alamolhoda SH, Baghban AA, Mirabi P. Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women. J Res Med Sci. 2014 Jul;19(7):629-33. Abstract
  16. Dennis CL, Jackson K, Watson J. Interventions for treating painful nipples among breastfeeding women. Cochrane Database Syst Rev. 2014 Dec 15;(12):CD007366. Abstract
  17. Kirsch F, Horst K, Rohrig W, et al. Tracing metabolite profiles in human milk: Studies on the odorant 1,8-cineole transferred into breast milk after oral intake. Metabolomics. 2013;3:47–71
  18. Posadzki P, Watson LK, Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med (Lond). 2013 Abstract Full text (link to original source)
  19. Posadzki P, Watson L, Ernst E. Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews. Eur J Clin Pharmacol. 2013 Abstract
  20. Kennedy DA, Lupattelli A, Koren G, Nordeng H. Herbal medicine use in pregnancy: results of a multinational study. BMC Complement Altern Med. 2013 Abstract Full text (link to original source) Full text (in our servers)
  21. Sim TF, Sherriff J, Hattingh HL, Parsons R, Tee LB. The use of herbal medicines during breastfeeding: a population-based survey in Western Australia. BMC Complement Altern Med. 2013 Abstract Full text (link to original source) Full text (in our servers)
  22. Alves JG, de Brito Rde C, Cavalcanti TS. Effectiveness of Mentha piperita in the Treatment of Infantile Colic: A Crossover Study. Evid Based Complement Alternat Med. 2012;2012:981352. Abstract
  23. Efferth T, Kaina B. Toxicities by herbal medicines with emphasis to traditional Chinese medicine. Curr Drug Metab. 2011 Abstract
  24. WHO. World Health Organization. WHO monographs on medicinal plants commonly used in the Newly Independent States (NIS). WHO monographs. 2010 Full text (in our servers)
  25. Abdulrazzaq YM, Al Kendi A, Nagelkerke N. Soothing methods used to calm a baby in an Arab country. Acta Paediatr. 2009 Abstract
  26. Hausner H, Bredie WL, Mølgaard C, Petersen MA, Møller P. Differential transfer of dietary flavour compounds into human breast milk. Physiol Behav. 2008 Sep 3;95(1-2):118-24. Abstract
  27. Sayyah Melli M, Rashidi MR, Delazar A, Madarek E, Kargar Maher MH, Ghasemzadeh A, Sadaghat K, Tahmasebi Z. Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial. Int Breastfeed J. 2007 Abstract
  28. Melli MS, Rashidi MR, Nokhoodchi A, Tagavi S, Farzadi L, Sadaghat K, Tahmasebi Z, Sheshvan MK. A randomized trial of peppermint gel, lanolin ointment, and placebo gel to prevent nipple crack in primiparous breastfeeding women. Med Sci Monit. 2007 Sep;13(9):CR406-411. Abstract
  29. Crotteau CA, Wright ST, Eglash A. Clinical inquiries. What is the best treatment for infants with colic? J Fam Pract. 2006 Abstract
  30. Westfall RE. Use of anti-emetic herbs in pregnancy: women's choices, and the question of safety and efficacy. Complement Ther Nurs Midwifery. 2004 Abstract
  31. Martin D, Valdez J, Boren J, Mayersohn M. Dermal absorption of camphor, menthol, and methyl salicylate in humans. J Clin Pharmacol. 2004 Abstract
  32. WHO. World Health Organization. Geneva. WHO monographs on selected medicinal plants. Volume 2. WHO monographs. 2002 Full text (link to original source) Full text (in our servers)
  33. Kopec K. Herbal medications and breastfeeding. J Hum Lact. 1999 Jun;15(2):157-61. Review. No abstract available. Abstract
  34. Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med. 1998 Abstract
  35. Hsu CK, Leo P, Shastry D, Meggs W, Weisman R, Hoffman RS. Anticholinergic poisoning associated with herbal tea. Arch Intern Med. 1995 Abstract

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