Skip to content
Winnowleaf home

Supplements While Breastfeeding: What's Safe, What Helps Milk Supply and What to Skip

While breastfeeding, most people need only a few supplements: iodine (150 mcg a day, as the American Thyroid Association advises), vitamin B12 if you eat no animal foods, and vitamin D drops for the baby, which raised babies' levels in trials (grade C). Milk-supply herbs such as fenugreek and moringa rest on very low-certainty evidence (grade C). Skip high-dose vitamin A, ashwagandha and berberine, and agree each supplement with your midwife or doctor.

Published How we grade evidenceEditorial policy

The short version

  • Vitamin D drops for the baby: grade C. Drops raised breastfed babies' vitamin D levels in a Cochrane review (low certainty) (Tan 2020), and US pediatricians advise them for every breastfed baby (Wagner 2008).
  • Iodine: grade C. Milk iodine follows the mother's intake, and the American Thyroid Association advises a daily supplement with 150 mcg of iodine while breastfeeding (LactMed: Iodine).
  • Vitamin B12 if you eat no animal foods: grade C. Babies of vegan or vegetarian mothers are at particular risk of B12 deficiency (LactMed: Vitamin B12).
  • Milk-supply herbs such as fenugreek, moringa and shatavari: grade C. A Cochrane review of 27 trials of natural products rated the evidence very low certainty (Foong 2020).
  • DHA (fish oil): grade C, mixed. Giving DHA to breastfeeding mothers did not clearly improve children's development in a Cochrane review of 8 trials (Delgado-Noguera 2015).
  • Skip high-dose vitamin A, ashwagandha and berberine; the reasons are below (LactMed: Vitamin A; LactMed: Withania; LactMed: Goldenseal).

LactMed is the free US government database on medicines and supplements in breastfeeding (LactMed home). Make each call with your midwife, family doctor or lactation consultant.

SupplementWhat the evidence showsGrade
Vitamin D drops for the babyRaise the baby's vitamin D level; low certaintyC
IodineMilk iodine follows the mother's intake; one trial in a low-iodine areaC
Vitamin B12 (vegan or vegetarian diet)Can improve the baby's B12 status; prenatal amounts raise milk B12 only slightlyC
DHA (fish oil)No clear benefit to children's development; reviews disagreeC
IronFor low iron found on a blood test; little reaches the milkC
Fenugreek, moringa, shatavariSome trials found more milk; very low certaintyC
Lactation cookiesNo difference in milk production in one trialC
High-dose vitamin ANo benefit for mother or baby; avoidSkip

Does a breastfed baby need vitamin D drops?

Grade C. Yes, by US pediatric guidance, though the trials are small. Mothers taking 400 to 2,000 IU of vitamin D a day still make milk with too little for the baby, so the baby needs its own drops (LactMed: Vitamin D). The American Academy of Pediatrics recommends daily vitamin D drops for all babies, including exclusively breastfed ones, starting soon after birth (Wagner 2008). Ask your baby's doctor about daily vitamin D drops and how much to give.

In the Cochrane review, daily drops raised babies' vitamin D levels (6 trials, 334 babies) and cut insufficiency (4 trials, 274 babies), both low certainty; effects on bone mineral content and rickets were unclear (Tan 2020).

Could the mother take it instead? In a trial with 334 mother and baby pairs, babies of mothers taking 6,400 IU a day had vitamin D levels no different from babies given standard daily drops (Hollis 2015). That was a research dose above the adult upper limit, not a recommendation; don't take that much unless your doctor advises it. Upper limit for adults: 4,000 IU (100 mcg) of vitamin D a day, because more can cause high blood calcium; take more only with blood tests or your clinician's advice (NIH ODS; check your stack).

Should you take iodine while breastfeeding?

Grade C. Iodine is worth checking first, because few breastfeeding parents take it. Your baby needs iodine to make thyroid hormone, and milk iodine tracks the mother's intake. LactMed reports the US recommended intake (RDA) while breastfeeding of 290 mcg a day in total from food and supplements, the American Thyroid Association's advice of a daily 150 mcg supplement, lower milk iodine in vegan and vegetarian mothers, and that only 19% of US breastfeeding women took an iodine supplement in a 2011 to 2014 survey (LactMed: Iodine).

The strongest trial was in Morocco, in an area with moderate-to-severe iodine deficiency: in 241 mother and baby pairs, one large dose of iodised oil given to the mother (not a daily supplement) raised milk and baby iodine more than dosing the babies directly, and fewer babies had low thyroid function (Bouhouch 2014). More is not better: very large amounts, such as seaweed soup, have caused short-lived low thyroid function in breastfed babies (LactMed: Iodine). Upper limit for adults: 1,100 mcg of iodine a day, because more can upset the thyroid; take more only with blood tests or your clinician's advice (NIH ODS; check your stack). On thyroid medicine, ask your doctor first.

Do you need vitamin B12 if you're vegan or vegetarian?

Grade C. Yes: vitamin B12 comes almost only from animal foods, and your baby gets it from your milk. LactMed lists breastfed babies of mothers who eat few or no animal foods, or who have pernicious anemia (a condition that blocks B12 absorption), as the groups most at risk. In babies, B12 deficiency can cause anemia, weak muscle tone, poor growth, seizures and delayed development. The small amounts in prenatal vitamins (1 to 10 mcg) raise milk levels only slightly; mothers who are low may need more, and the baby may need its own B12 (LactMed: Vitamin B12). If you eat no animal foods, ask for a B12 check and tell your baby's doctor. No upper limit has been set for B12 (NIH ODS). Metformin can also lower B12 (does metformin lower vitamin B12?).

Should you take DHA or fish oil while breastfeeding?

Grade C, mixed. Milk DHA follows your diet, and supplements raise it within hours (LactMed: Marine Oils). A Cochrane review of 8 trials with 1,567 women found no clear improvement in children's development, eyesight or growth; one study found better attention scores at age 5 (Delgado-Noguera 2015). A 2025 analysis found no significant effect on mental development when mothers took omega-3 in pregnancy or breastfeeding, but did find better language scores (Liu 2025). LactMed cites other reviews that found better language and movement scores, so the reviews disagree (LactMed: Marine Oils). The FDA advises 8 to 12 ounces a week of lower-mercury fish while breastfeeding (FDA fish advice). If you take fish oil and a blood thinner, read can I take fish oil with Eliquis?.

Should you take iron after giving birth?

Grade C. Take iron when a blood test shows low iron or anemia, not by default. Prenatal-vitamin iron doesn't change milk iron, and higher doses for a mother's anemia change it very little and are not expected to harm the baby (LactMed: Iron Salts). A 2024 Cochrane review of anemia after birth compared iron by drip with iron tablets, among other options; most of its evidence was low or very low certainty, and tablets caused more constipation (10 trials, 1,798 women) (Jensen 2024). Upper limit for adults: 45 mg of iron a day; more upsets the stomach, and iron tablets are deadly to children, so keep the bottle out of reach (NIH ODS; check your stack). If you take levothyroxine, space them apart: can I take iron, calcium or magnesium with levothyroxine?.

Do fenugreek, moringa or other herbs increase milk supply?

Grade C. Some trials found more milk, but the evidence is weak. Supply depends most on how often and how well milk is removed, so LactMed says milk-supply products (galactagogues) should never replace a feeding check by a midwife or lactation consultant (LactMed: Fenugreek). Cochrane reviewers looked at 41 trials (3,005 mothers of healthy term babies), 27 of them on natural products. Milk volume results (13 studies, 962 mothers) varied too much to pool, the evidence was very low certainty, and reported side effects were minor, such as urine that smelled like maple syrup in mothers and hives in babies (Foong 2020).

  • Fenugreek. A network analysis of 5 studies (122 women on fenugreek) found more milk than placebo when 4 were pooled (Khan 2018). LactMed lists diarrhea, gas, a maple syrup smell, allergic reactions (it can cross-react with chickpeas and peanuts), lower blood sugar at high doses, bleeding with warfarin and rare liver injury; in one US survey, 45% of 85 users reported a side effect (LactMed: Fenugreek). Our database grades fenugreek B for milk production from two small herbal tea trials; we give C because Cochrane rated this evidence very low certainty.
  • Moringa. LactMed cites a review of 14 studies (865 women) that found higher prolactin (the milk hormone) and milk volume, and no serious short-term side effects; it may promote blood clotting, so take care if your clot risk is high (LactMed: Moringa).
  • Shatavari. In a 2025 placebo-controlled trial in 113 women after childbirth, a root extract led to more milk at 72 hours and earlier breast fullness, with no side effects reported (Ajgaonkar 2025). Our database grades shatavari D for milk production; we give C because this randomized trial adds to the older studies.
  • Lactation cookies. In 176 breastfeeding parents who felt their supply was adequate, a month of daily cookies did not change milk production (Palacios 2023).
  • Brewer's yeast and milk thistle. LactMed found no valid human trials showing either one increases milk (LactMed: Brewer's Yeast; LactMed: Milk Thistle). That is an absence of evidence, not proof they fail.

What about domperidone for milk supply?

Domperidone is a prescription medicine, not a supplement; this guide gives no doses. In mothers pumping for premature babies, 5 trials (194 women) found about 88 mL more milk a day than placebo (Grzeskowiak 2018). It is not approved in the US, and the FDA warned breastfeeding women not to use it because of safety concerns, including reports of heart rhythm problems, cardiac arrest and sudden death with an injected form of the drug (FDA warning). In people using it for other reasons, current use was linked to a 70% higher risk of dangerous heart rhythms and sudden cardiac death (Leelakanok 2016). Any decision belongs with your doctor.

Is it safe to take common supplements while breastfeeding?

LactMed's short answers for supplements people often ask about:

  • Magnesium: at usual amounts, no special precautions; a baby absorbs little magnesium by mouth (LactMed: Magnesium Oxide).
  • Melatonin: no safety data in breastfeeding; short-term use of usual evening doses is unlikely to harm the baby, though some authors advise against it (LactMed: Melatonin).
  • CoQ10: a normal part of milk, but no data on taking it as a supplement while breastfeeding (LactMed: Coenzyme Q10).
  • Turmeric: no data on how much reaches milk; one small study found no problems in babies; it may raise bleeding risk with warfarin (LactMed: Turmeric).
  • Creatine: milk levels after supplements have never been measured, and it can raise a baby's creatinine test; LactMed advises avoiding it unless a clinician prescribes it (LactMed: Creatine).
  • St John's wort: one study found slightly more colic, drowsiness and lethargy in babies, it interacts with many medicines, and LactMed says another option may be preferred, especially with a newborn or premature baby (LactMed: St. John's Wort). Read can I take St John's wort with birth control? and with SSRIs?.

What we'd skip

  • High-dose vitamin A (retinol). LactMed advises against more than 3,000 mcg (10,000 IU) a day (LactMed: Vitamin A). In a Cochrane review of 14 trials (25,758 mother and baby pairs), large doses after birth raised milk vitamin A but did not improve health or survival for mothers or babies (Oliveira 2016). Upper limit for adults: 3,000 mcg (10,000 IU) of preformed vitamin A a day, because more can cause birth defects and liver damage; take more only with blood tests or your clinician's advice (NIH ODS; check your stack). Beta-carotene does not count toward this limit.
  • Ashwagandha. No data exist on whether it passes into milk or is safe for babies, and LactMed advises avoiding it, especially with a newborn or premature baby (LactMed: Withania).
  • Berberine and goldenseal. Berberine can push bilirubin (the yellow pigment in jaundice) off its carrier protein, which raises concern about brain damage in newborns; how much reaches milk is unknown, and most sources advise keeping newborns away from it (LactMed: Goldenseal).
  • Sage and peppermint in medicinal amounts if your supply is low. Both are used to dry up milk. No study has tested sage on milk supply (LactMed: Sage), and high doses of peppermint reduced milk in lab and animal studies (LactMed: Peppermint).

Safety and interactions

  • Some cold medicines lower supply. A single dose of the decongestant pseudoephedrine cut milk production, and LactMed advises against it while your supply is still settling or low (LactMed: Pseudoephedrine).
  • Herbs and blood thinners. Fenugreek and turmeric may raise bleeding risk with warfarin, and moringa may promote clotting (LactMed: Fenugreek; LactMed: Turmeric; LactMed: Moringa). No interaction studies were found for most herbs in breastfeeding mothers; ask your pharmacist.
  • Supplement labels can be wrong. Supplements are not approved before sale, and contents can differ from the label (LactMed: Fenugreek). Our guide to choosing a quality supplement explains third-party testing.
  • Add it up. A prenatal vitamin plus extra vitamin D, iodine or iron can pass an upper limit. Check your stack against the adult limits.
  • Don't stop a prescribed medicine on your own; ask the prescriber or pharmacist.

When to see a doctor

Call your midwife or doctor the same day if:

  • your baby has fewer wet nappies, dark urine, is very sleepy or hard to wake for feeds, is losing weight, or has yellow skin that is spreading;
  • your baby gets a rash, hives, diarrhea or unusual sleepiness after you start a supplement or herb (stop it and ask);
  • you have a fever with a hot, red, painful area on the breast;
  • you feel low, hopeless or anxious most days, or have thoughts of harming yourself or your baby (get help now);
  • you follow a vegan diet and notice numbness, tingling or unusual tiredness.

Decide on any supplement with your midwife, family doctor or lactation consultant.

FAQ

Should I keep taking my prenatal vitamin while breastfeeding? Check the label. You want iodine in it (the American Thyroid Association advises 150 mcg a day while breastfeeding) and no more than 3,000 mcg (10,000 IU) of preformed vitamin A. Your baby still needs vitamin D drops unless your doctor advises another plan.

Does fenugreek increase milk supply? Possibly a little. Pooled small trials found more milk than placebo, but a Cochrane review rated the evidence very low certainty (grade C). Side effects include diarrhea, a maple syrup smell and allergic reactions in people who react to chickpeas or peanuts.

Is ashwagandha safe while breastfeeding? No data exist on whether it reaches milk or is safe for babies. LactMed advises avoiding it, especially with a newborn or premature baby.

Can I take melatonin while breastfeeding? There are no safety data in breastfeeding. LactMed says short-term use of usual evening doses is unlikely to harm the baby, though some authors advise against it.

Do breastfed babies need vitamin D drops? Yes. The American Academy of Pediatrics recommends daily vitamin D drops for all breastfed babies from soon after birth, because breast milk is low in vitamin D. Ask your baby's doctor about the drops and how much to give.

Sources

  1. Tan ML, et al. Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health. Cochrane Database Syst Rev. 2020. PubMed 33305822 · doi:10.1002/14651858.CD013046.pub2
  2. Wagner CL, et al. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008. PubMed 18977996 · doi:10.1542/peds.2008-1862
  3. National Institute of Child Health and Human Development. Iodine. Drugs and Lactation Database (LactMed). 2026. PubMed 30000537 · NCBI Bookshelf NBK501477
  4. National Institute of Child Health and Human Development. Vitamin B(12). Drugs and Lactation Database (LactMed). 2026. PubMed 30489717 · NCBI Bookshelf NBK534419
  5. Foong SC, et al. Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. Cochrane Database Syst Rev. 2020. PubMed 32421208 · doi:10.1002/14651858.CD011505.pub2
  6. Delgado-Noguera MF, et al. Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. Cochrane Database Syst Rev. 2015. PubMed 26171898 · doi:10.1002/14651858.CD007901.pub3
  7. National Institute of Child Health and Human Development. Vitamin A. Drugs and Lactation Database (LactMed). 2024. PubMed 30000990 · NCBI Bookshelf NBK513060
  8. National Institute of Child Health and Human Development. Withania. Drugs and Lactation Database (LactMed). 2024. PubMed 30000965 · NCBI Bookshelf NBK501905
  9. National Institute of Child Health and Human Development. Goldenseal. Drugs and Lactation Database (LactMed). 2025. PubMed 30000926 · NCBI Bookshelf NBK501866
  10. National Institute of Child Health and Human Development. Vitamin D. Drugs and Lactation Database (LactMed). 2024. PubMed 29999973 · NCBI Bookshelf NBK500914
  11. Hollis BW, et al. Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics. 2015. PubMed 26416936 · doi:10.1542/peds.2015-1669
  12. Bouhouch RR, et al. Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. 2014. PubMed 24622750 · doi:10.1016/S2213-8587(13)70155-4
  13. National Institute of Child Health and Human Development. Marine Oils. Drugs and Lactation Database (LactMed). 2026. PubMed 30000958 · NCBI Bookshelf NBK501898
  14. Liu Y, et al. N-3 Fatty Acid Supplementation in Mothers and Infants for Childhood Psychomotor and Cognitive Development: An Updated Systematic Review and Meta-Analysis. Matern Child Nutr. 2025. PubMed 39609259 · doi:10.1111/mcn.13767
  15. National Institute of Child Health and Human Development. Iron Salts. Drugs and Lactation Database (LactMed). 2026. PubMed 34958537 · NCBI Bookshelf NBK575923
  16. Jensen MCH, et al. Treatment for women with postpartum iron deficiency anaemia. Cochrane Database Syst Rev. 2024. PubMed 39670550 · doi:10.1002/14651858.CD010861.pub3
  17. National Institute of Child Health and Human Development. Fenugreek. Drugs and Lactation Database (LactMed). 2026. PubMed 30000838 · NCBI Bookshelf NBK501779
  18. Khan TM, et al. Effectiveness of fenugreek as a galactagogue: A network meta-analysis. Phytother Res. 2018. PubMed 29193352 · doi:10.1002/ptr.5972
  19. National Institute of Child Health and Human Development. Moringa. Drugs and Lactation Database (LactMed). 2026. PubMed 30000959 · NCBI Bookshelf NBK501899
  20. Ajgaonkar A, et al. Shatavari (Asparagus racemosus Willd) root extract for postpartum lactation: A randomised, double-blind, placebo-controlled study. J Obstet Gynaecol. 2025. PubMed 41055223 · doi:10.1080/01443615.2025.2564168
  21. Palacios AM, et al. Effectiveness of lactation cookies on human milk production rates: a randomized controlled trial. Am J Clin Nutr. 2023. PubMed 36921902 · doi:10.1016/j.ajcnut.2023.03.010
  22. National Institute of Child Health and Human Development. Brewer’s Yeast. Drugs and Lactation Database (LactMed). 2026. PubMed 34292694 · NCBI Bookshelf NBK572248
  23. National Institute of Child Health and Human Development. Milk Thistle. Drugs and Lactation Database (LactMed). 2026. PubMed 30000830 · NCBI Bookshelf NBK501771
  24. Grzeskowiak LE, et al. Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis. BJOG. 2018. PubMed 29469929 · doi:10.1111/1471-0528.15177
  25. Leelakanok N, et al. Domperidone and Risk of Ventricular Arrhythmia and Cardiac Death: A Systematic Review and Meta-analysis. Clin Drug Investig. 2016. PubMed 26649742 · doi:10.1007/s40261-015-0360-0
  26. National Institute of Child Health and Human Development. Magnesium Oxide. Drugs and Lactation Database (LactMed). 2024. PubMed 29999630 · NCBI Bookshelf NBK500570
  27. National Institute of Child Health and Human Development. Melatonin. Drugs and Lactation Database (LactMed). 2026. PubMed 30000923 · NCBI Bookshelf NBK501863
  28. National Institute of Child Health and Human Development. Coenzyme Q10. Drugs and Lactation Database (LactMed). 2021. PubMed 30000847 · NCBI Bookshelf NBK501788
  29. National Institute of Child Health and Human Development. Turmeric. Drugs and Lactation Database (LactMed). 2025. PubMed 30000906 · NCBI Bookshelf NBK501846
  30. National Institute of Child Health and Human Development. Creatine. Drugs and Lactation Database (LactMed). 2025. PubMed 30000913 · NCBI Bookshelf NBK501853
  31. National Institute of Child Health and Human Development. St. John's Wort. Drugs and Lactation Database (LactMed). 2025. PubMed 30000829 · NCBI Bookshelf NBK501770
  32. Oliveira JM, et al. Vitamin A supplementation for postpartum women. Cochrane Database Syst Rev. 2016. PubMed 27012320 · doi:10.1002/14651858.CD005944.pub3
  33. National Institute of Child Health and Human Development. Sage. Drugs and Lactation Database (LactMed). 2025. PubMed 30000875 · NCBI Bookshelf NBK501816
  34. National Institute of Child Health and Human Development. Peppermint. Drugs and Lactation Database (LactMed). 2026. PubMed 30000911 · NCBI Bookshelf NBK501851
  35. National Institute of Child Health and Human Development. Pseudoephedrine. Drugs and Lactation Database (LactMed). 2026. PubMed 30000144 · NCBI Bookshelf NBK501085