Cayenne peppers (Capsicum species) contain capsaicin and related compounds which cause the hot, spicy flavor, as well as numerous other components. Capsicum has no specific lactation-related uses. It appears that Capsicum components can be excreted into milk in amounts that affect breastfed infants because skin rashes have been reported in the breastfed infants of women who ate foods spiced with red peppers. Capsaicin is used topically for pain. Application of Capsicum or capsaicin to the mother's skin should not affect the infant as long as the infant's skin does not come into direct contact with the areas of skin that have been treated. However, severe pain has been reported in an infant who ingested capsaicin from the mother’s skin. Do not apply capsaicin cream to the breast or other parts of the body that the infant might contact. Capsicum may increase the risk of bleeding and should be used cautiously in patients taking anticoagulant or antiplatelet medications. Cross reactions can occur in those allergic to members of the Solanaceae family of plants (e.g., potatoes, tomatoes, paprika, Jimson weed). Prolactin elevation from breastfeeding can decrease the sensation of pain from capsaicin in nursing mothers.
Capsicum is "generally recognized as safe" (GRAS) as a food by the U.S. Food and Drug Administration. Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.