This sheet talks about exposure to echinacea in a pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is echinacea?

Echinacea is an herb that comes from the roots, stem, and leaves of the plant Echinacea purpurea (Purple coneflower). Dried roots of Echinacea angustifolia and Echinacea pallida are also used. The type of active ingredients can vary widely. The amount and strength of the active ingredients depends on the type of echinacea plant used, the part of the plant used, and how it is made.

Echinacea comes in many forms, such as teas, extracts, capsules and tablets, and preparations that go on the skin (topical use). Some kinds of echinacea may be included in dietary supplements. When given as a tincture, the product might have a significant amount of alcohol.

In the United States and other countries, including Canada, herbal remedies and dietary supplements such as echinacea preparations are not evaluated according to the same criteria as prescribed medications and do not have set standards for preparation, safety, or degree of effectiveness. For more information on herbal products in general, please see our fact sheet at: https://mothertobaby.org/fact-sheets/herbal-products-pregnancy/pdf/.

I take echinacea. Can it make it harder for me to get pregnant?

Studies have not been done to see if taking echinacea could make it harder for a woman to get pregnant.

I just found out I am pregnant. Should I stop taking echinacea?

Talk with your healthcare provider. Given the unclear benefits of echinacea, other better studied cold and flu remedies and frequent hand washing are preferred during pregnancy.

Does taking echinacea increase the chance for miscarriage? 

Miscarriage can occur in any pregnancy. Two studies in animals suggested that echinacea products might increase the risk of miscarriage. However, it is not clear how the preparations and dose levels used in the animal studies compare with those used in humans. There are no studies looking at echinacea and the chance for miscarriage in human pregnancy.

Does taking echinacea in the first trimester increase the chance of birth defects?

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. There have been small studies looking at exposure to echinacea during pregnancy. No increase in birth defects was seen in these studies. The exact timing of the exposure was not mentioned in the majority of women but many reported use early in pregnancy.

Herbal products are not monitored for other possibly harmful substances (called contaminants) such as metals, pesticides, chemicals, microorganisms, or other ingredients not listed on the label. These contaminants may have their own negative effects on a pregnancy. Some echinacea preparations contain alcohol. Using large amounts of products that contain alcohol could result in birth defects or other alcohol-related problems. Alcohol from any source should be avoided in pregnancy.

Could taking echinacea during my pregnancy cause other kinds of problems?

There are no studies looking at echinacea and pregnancy complications or effects to the child’s behavior or development. Some preparations have been found to be contaminated by heavy metals like lead. High blood lead levels during pregnancy can harm a baby’s brain development.

Can I breastfeed while taking echinacea?

There is no information on the use of echinacea in nursing mothers or infants. Because of the lack of data, other products that have more information may be recommended for use during breastfeeding. If you use echinacea and suspect that the baby has symptoms such as stomach upset, diarrhea, constipation, skin rash or allergic reactions, contact the child’s healthcare provider. Talk to your healthcare provider about all of your breastfeeding questions.

If a man takes echinacea, could it affect his fertility (ability to get partner pregnant) or increase the chance of birth defects? 

Studies have not been done in humans to see if taking echinacea could make it harder for a man to get his partner pregnant. A father’s use of echinacea would be unlikely to cause a birth defect. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

Selected References:

• Barcz E, et al. 2007. Influence of Echinacea purpurea intake during pregnancy on fetal growth and tissue angiogenic activity. Folia Histochemica et Cytobiologica 45:Supp. 1; 35-39.
• Chow G, et al. 2006. Dietary echinacea purpurea during murine pregnancy: Effect on maternal hemopoiesis and fetal growth. Biol Neonate; 89: 133-138.
• Gallo M, et al. 2000. Pregnancy outcome following gestational exposure to echinacea. Arch Intern Med. 160:3141-3143
• Heitmann K, et al. 2016. Pregnancy outcome after prenatal exposure to echinacea: The Norwegian Mother and Child Cohort Study. Eur J Clin Pharmacol. 72: 623-630.
• Huntley AL, et al. 2005. The safety of herbal medicinal products derived from Echinacea Drug Saf 28(5):387-400.
• Linde K, et al. 2009. Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD000530. DOI: 10.1002/14651858.CD000530.pub2.
• Natural Standard (Ed). Herbs & Supplements – Echinacea (E. angustifolia DC, E. pallida, E. purpurea). Nature Medicine Quality Standard. [Retrieved on November 2014]. www.naturalstandard.com
• Ondrizek RR, et al. 1999. Inhibition of human sperm motility by specific herbs used in alternative medicine. J Assist Reprod Genet. 16(2):87-91.
• Perri D, et al. 2006. Safety and efficacy of echinacea (Echinacea angustifolia, E. purpurea and E. pallida) during pregnancy and lactation. Can J Clin Pharmacol 13(3):e261-7.