Marshmallow (Althaea officinalis) root contains polysaccharide mucilage composed L-rhamnose, D-galactose, D-galacturonic acid, and D-glucuronic acid. Topical marshmallow preparations have been advocated for treating sore, cracked nipples and breast pain. Orally, marshmallow is a purported galactogogue, and is included in some proprietary mixtures promoted to increase milk supply; however, no scientifically valid clinical trials support this use. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[4,5] No data exist on the excretion of any components of marshmallow into breastmilk or on the safety and efficacy of marshmallow in nursing mothers or infants. Marshmallow is generally well tolerated in adults, with allergic reactions reported rarely. Marshmallow is "generally recognized as safe" (GRAS) in amounts found in foods by the U.S. Food and Drug Administration. Although no data exist on the safety of marshmallow root during breastfeeding, it is unlikely to be harmful to the breastfed infant.
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.