Drugs in Pregnancy and Lactation: Tenth Edition

RASPBERRY LEAF

Herb

PREGNANCY RECOMMENDATION: Compatible

BREASTFEEDING RECOMMENDATION: Compatible

PREGNANCY SUMMARY

Raspberry leaf tea is one of the most common tonics used by pregnant women. Although it appears to have little if any toxicity, its efficacy as a uterine tonic to shorten labor is questionable. One source recommended that pregnant women should not use the tea without guidance of a health care professional because it can cause uterine contractions and might have estrogenic effects (1). However, because of the absence of reports of embryo, fetal, or newborn harm, if a woman chooses to use it in pregnancy, there is no reason to counsel against it.

FETAL RISK SUMMARY

Raspberry leaf, also known as red raspberry, is derived from the plant, Rubus idaeus (Eurasian) or R. strigosus (North American). The principal compounds isolated from the leaves are tannins and flavonoids. Raspberry leaf tea has been used for diarrhea and as mouthwash because of its astringent properties. It also is used as a uterine tonic to stimulate labor. The typical doses taken as a tea are 1.5–2.4 g/day. Although the information is nearly nonexistent, there is no evidence that raspberry tea is toxic (2). One review considered the chemicals in raspberry to be so common that the need for caution was no different from that of foods consumed in pregnancy (3).

Raspberry tea is used by thousands of women during pregnancy (36). Raspberry leaf also is combined with other herbs to make teas promoted for pregnancy (7). One popular product recommends it for a “healthy” pregnancy and to “tone the uterine muscles and prepare the womb for childbirth.” The manufacturer of the product recommends its use throughout pregnancy and in first few postpartum weeks. The tea is a combination of the leaves of raspberry, spearmint, strawberry, lemongrass, alfalfa, lemon verbena, rose hip, and fennel seed (7).

Raspberry tea is often prescribed by nurse-midwives. The most common uses of the tea during gestation are to treat nausea and vomiting (35) and to stimulate labor (5,6). A national survey found that among nurse-midwives who used herbal preparations to stimulate labor, 45% used black cohosh, 60% used evening primrose oil, 63% used raspberry leaf, and 90% used castor oil (6). No pregnancy complications were reported with the free use of raspberry leaf tea in late pregnancy. Although the dose recommended by the nurse-midwives was not cited, the authors cited a common dosage of 2 g dried leaves steeped in 240 mL boiling water for 5 minutes (6).

A 2001 report described a double-blind, randomized, placebo-controlled trial conducted to determine if raspberry leaf tablets (1.2 g/tablet) were effective and safe in terms of labor and birth outcomes (8). Subjects (N = 96) and controls (N = 96) were given 2 tablets/day of either raspberry leaf or placebo from 32 weeks’ gestation until labor. There were no significant differences between the groups in the length of labor or the stages of labor, the mode of delivery, admissions to the neonatal intensive care unit, or birth outcomes, including Apgar scores and birth weight (8).

BREASTFEEDING SUMMARY

There are no reports describing the use of raspberry leaf during lactation. The near absence of reported toxicity with raspberry leaf tea suggests that the tea can be safely consumed during lactation. The risk to a nursing infant appears to be nil.

References

1.Raspberry Leaf. In: Natural Medicines Comprehensive Database. 5th ed. Stockton, CA: Therapeutic Research Faculty, 2003:1105–6.

2.Raspberry. In: The Review of Natural Products. St. Louis, MO: Wolters Kluwer Health, 2004.

3.Johns T, Sibeko L. Pregnancy outcomes in women using herbal therapies. Birth Defects Res B Dev Reprod Toxicol 2003;68:501–4.

4.Wilkinson JM. What do we know about herbal morning sickness treatments? A literature survey. Midwifery 2000;16:224–8.

5.Allaire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy: a survey of North Carolina certified nurse-midwives. Obstet Gynecol 2000;95:19–23.

6.McFarlin BL, Gibson MH, O’Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse-Midwifery 1999;44:205–16.

7.Tsui B, Dennehy D, Tsourounis C. A survey of dietary supplement use during pregnancy at an academic medical center. Am J Obstet Gynecol 2001;185:433–7.

8.Simpson M, Parsons M, Greenwood J, Wade K. Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwifery Women’s Health 2001;46:51–9.



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