However, what’s the procedure for using these plant compounds during pregnancy and into lactation (breastfeeding)? The primary concern regarding the use of essential oils during pregnancy appears to be the risk of essential oil components crossing over into the placenta. According to Robert Tisserand, one of the world's leading experts in aromatherapy, crossing the placenta does not always mean that there is a risk of toxicity to the fetus; risk will correlate to the toxicity and the plasma concentration of the compound in question.
Because there is a lack of concise, scientific information regarding the toxicity of essential oils during pregnancy, it is considered “best practice” to adhere to the general safety guidelines for each essential oil. Safe usage is determined and set forth by the International Fragrance Association (IFRA).
According to Tisserand, the following essential oils should be avoided during pregnancy: - Wormwood
- Rue
- Oak moss
- Lavandula stoechas (Spanish Lavender)
- Camphor
- Parsley seed
- Sage
- Hyssop
The following (properly diluted) essential oils do appear to be safe for use during pregnancy when diluted appropriately: - Benzoin
- Bergamot
- Black pepper
- Chamomile (German & Roman)
- Clary sage
- Cypress
- Eucalyptus
- Frankincense
- Geranium
- Ginger
- Grapefruit
- Juniper
- Lavender
- Lemon
- Mandarin
- Marjoram (sweet)
- Neroli
- Petitgrain
- Rose
- Sandalwood
- Orange (sweet)
- Tea tree
- Ylang-ylang
Some of the reasons that contraindicated essential oils should be avoided during pregnancy and breastfeeding (lactation) include the following:- Abortifacient – causes abortion/terminates pregnancy.
- Carcinogenic – causes cancer.
- Embryotoxic – toxic to the growing fetus (specifically in the first 8-12 weeks of gestation).
- Fetotoxic – toxic to the growing fetus.
- Hepatotoxic – toxic to the liver.
- Nephrotoxic – toxic to the kidney.
- Teratogenic – ability to cause malformations in a growing fetus.
It is widely recommended to avoid the use of all essential oils in the first trimester since this is considered the most delicate time during pregnancy. In general, essential oil use during pregnancy should be limited to infrequent or minimal.
As a formulator, it is critical to know which oils are regarded as unsafe to use during pregnancy and breastfeeding. Some classes of essential oils, such as those extracted by solvents (sometimes called absolutes) should be avoided entirely during pregnancy. Essential oils (absolutes) extracted by solvents may contain traces of butane, hexane, or other solvents used in the extraction process. Exposure to solvents during the first trimester of pregnancy can increase the risk of congenital disabilities.
Pregnant and lactating women should not diffuse oils for long periods of time and should always use diffusers in a well-ventilated area. For example, open a window while the diffuser is running and do not close off small rooms while diffusers are in operation. Pregnant women often suffer from hyperosmia (a heightened sense of smell); tolerance to odors, even beneficial odors, may be markedly decreased compared with those who are not pregnant.
If you choose to use or manufacture with essential oils while you are pregnant or lactating, consider consulting with an aromatherapist specializing in the use of essential oils during pregnancy. Medical doctors usually do not have experience in proper handling of essential oils and will likely recommend complete avoidance to be cautious. Using respirators, proper ventilation and appropriate safety equipment as well as covering exposed skin can help to reduce the risk of accidental exposure to both mother and fetus.
Studies using essential oils with pregnant patients are few and far between for ethical reasons. One trial involving 513 women compared the use of Roman chamomile, clary sage, frankincense, lavender or mandarin essentials oils with standard medical care. In this study, the oil was applied using acupressure points, compress, footbath, massage or a birthing pool. A second trial involved 22 women who soaked for at least an hour in a bath with either essential oil of ginger or lemongrass added. These two trials found no difference between groups for pain intensity, assisted vaginal birth, cesarean section or the use of epidural. Insufficient evidence exists from randomized controlled trials regarding the benefits of aromatherapy on pain management in labor. [2]
A 2014 controlled, double-blind, randomized clinical trial aimed to determine the effect of inhaled lemon essential oil on nausea and vomiting in pregnancy. For this study, 100 pregnant women (6-16 weeks gestation) with moderate nausea and vomiting were split into two groups. The intervention group placed two drops of distilled lemon oil (diluted in almond oil) on a cotton ball and inhaled when they felt nauseous. Severity and frequency of nausea and vomiting decreased in both groups. However, the difference was much more significant in the Lemon group. Researchers concluded that inhaled lemon essential oil could be useful in reducing nausea and vomiting in pregnancy.
A 2012 Iranian triple-blind clinical trial evaluated the efficacy of 0.5% peppermint oil as symptomatic treatment for pregnancy pruritus (itch). A total of 96 women in their 2nd or 3rd trimester were assigned to either a control or treatment group. The control group was given plain sesame oil, and the treatment group received sesame oil with 0.5% peppermint oil. The oil was then applied twice daily for two weeks. Results indicated peppermint oil can be effective in reducing the severity of Pruritus gravidarum, or pregnancy itch. Peppermint oil showed no indication of carrying any risk in pregnancy.
The overall consensus appears to be that controlled use of aromatherapy during pregnancy and lactation can be beneficial in some instances. However, there should be an overabundance of caution and education involved to facilitate safe and effective usage. Consultation with a trained aromatherapist is suggested as well as safe usage and appropriate handling to minimize risk.
References:
Locate an aromatherapist: https://naha.org/find-an-aromatherapist
Smith CA, Collins CT, Crowther CA. Aromatherapy for pain management in labour. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD009215. DOI: 10.1002/14651858.CD009215.
Yavari kia, Parisa et al. “The Effect of Lemon Inhalation Aromatherapy on Nausea and Vomiting of Pregnancy: A Double-Blinded, Randomized, Controlled Clinical Trial.” Iranian Red Crescent Medical Journal 16.3 (2014): e14360. PMC. Web. 2 Apr. 2018.
Akhavan Amjadi, Marjan, Faraz Mojab, and Seyedeh Bahareh Kamranpour. “The Effect of Peppermint Oil on Symptomatic Treatment of Pruritus in Pregnant Women.” Iranian Journal of Pharmaceutical Research: IJPR 11.4 (2012): 1073–1077. Print.
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