Are Ayurvedic Tonics Safe during Breastfeeding?

While breastfeeding, we take the utmost care to avoid alcohol, but in spite of all the efforts, what if we are exposed to it and don’t even know? I previously discussed the link between alcohol and breastfeeding and its importance for the new mother and the baby. However, after writing it, one of the thoughts that kept haunting my mind was: What if the new moms are consuming alcohol unknowingly?

While discussing the thought of unknowing alcohol consumption by new moms with my dear sister, who is an Ayurvedic doctor, we realized that some of the Ayurvedic tonics (Kadhas, Asavas, and Arishtas) do have a considerable amount of alcohol. So, we decided to look deeper into it.

Ayurvedic preparations are an integral part of our daily life. If you are feeling a little under the weather, you will get a lot of advice from your friends, relatives, and next-door neighbors, and most of them are homemade ‘Kadhas’ or some ‘Churna’ or some Ayurvedic over-the-counter medications. We don’t even think much before buying these as they are ‘tried and tested’ for generations, mostly considered safe, and free of any side effects.

Where does the Alcohol come from?

Some of the Ayurvedic Kadhas, Asavas, or Arishtas contain alcohol. Mostly, in such preparations, herbs are boiled in water or infused in water. Fermenting agents, spices, jaggery, or honey are added and then the mixture is allowed to ferment for a specified period of time at a particular temperature. This is a very generalized version of the procedure. Each ‘Asava’ or ‘Arishta’ has its own ingredients and time-temperature combination.

During fermentation, sugars from honey or jaggery get converted into alcohol. So, although alcohol is not intentionally added to these tonics, it becomes a part of it during the process. Self-generated alcohol acts as a preservative. Many active substances from herbs get dissolved in alcohol. 

Most commonly Consumed Ayurvedic Tonics Post-Delivery

Many Kadhas, Asavas, or Arishtas are advised after the delivery. Usually, these are suggested by the older generation or the next-door neighbors and are consumed without much apprehension. Most of the pharmacies or ayurvedic shops have these tonics. These are mostly used for rapid post-delivery recovery, to regain strength, to normalize uterus size, to fight post-partum depression, and so on.

What are the Concerns?

1. If we consider the percentage of alcohol (I have taken a percentage that is on the higher side, 11%) and dosage (20 ml), then a mom consumes at least 2.2 ml of absolute alcohol at a time, which is almost ¼ of a standard drink! A standard drink in India contains 10 ml of absolute alcohol.
2. Alcohol is freely transferred from plasma to breast milk. Since tonics are taken daily, there is a chance that the baby might be getting exposed to low levels of alcohol on a regular basis. Unfortunately, there is not much information available on the effect of alcohol in low doses on babies.
3. Ayurvedic Kadhas, such as ‘Balantkadha’, are taken for the first 2 months after delivery. During this phase, the baby’s organs are still not fully developed. Their enzyme systems are yet to be fully functional. So, enzymes required to metabolize alcohol are secreted in very low amounts.

Thus, altogether, a chance of daily alcohol exposure to a baby’s immature organ systems certainly creates uneasiness in the mind.

Creating a Working Guideline

Ayurveda is a traditional Indian medicine system that is very popular and practiced in almost every Indian household. Most of the time, people buy Ayurvedic tonics without even consulting a doctor!

Since there are no guidelines available regarding the use of ayurvedic tonics during breastfeeding, I have created a working guideline. American Academy of Pediatrics (AAP) advises waiting for at least 2 hours after having a standard drink to breastfeed the baby. An American standard drink contains 14g of alcohol. So, let’s calculate, if one has to wait for 60 minutes after having 14g (which is 17.8 ml) of alcohol, then after having 2.2 ml of alcohol, one needs to wait for at least 10 minutes…

What can you do?

Here are some helpful suggestions, so you can enjoy the wonderful benefits of the Kadhas, or Asavas without worrying about their alcohol content.

1. Do not immediately breastfeed the baby after taking any Ayurvedic tonic. Wait for at least 10–15 minutes before you breastfeed your baby.
2. As a precaution, you may consume the tonic ‘after’ feeding the baby so that there is a sufficient window between the tonic consumption and the next feeding.
3. The list given above may not be complete. There are many more ayurvedic medications or preparations containing alcohol. You must always look at the packaging for any alcohol warnings or ask your ayurvedic practitioner regarding the medicine or tonic’s alcohol content.
4. Some of the ayurvedic medications might have other non-alcoholic alternatives, such as ‘capsules’ or ‘churna’; ask your ayurvedic doctor about it.
5. Fresh ‘Kadhas’ can be made at home. This eliminates the fermentation step, so alcohol doesn’t get generated. Consult your Ayurvedic practitioner for the procedure.

So, it is always helpful if we practice the above guidelines to prevent regular alcohol exposure to your little one. Let me know in the comments below if you know of any other Ayurvedic tonics or medications given post-delivery that might contain alcohol.