Elderberry has long been used as an immune booster in order to combat colds and even the flu, but research on the use of this herbal remedy during pregnancy has not quite caught up. Here’s what you need to know.

By Rachel Morgan Cautero
January 30, 2020
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I'm nearing the end of my second pregnancy, and unlike up to 80 percent of people, I haven't had morning sickness. But my health has taken a hit in other ways this pregnancy—think rhinitis, adult RSV, strep throat, and an ear infection.

With a toddler in school for the first time, I have a pretty good idea of where the germs are coming from. But treating my various ailments is another story since the list of approved medications to take during pregnancy can be limiting.

Enter elderberry. I'm not normally one for natural remedies, but I am desperate. Nearly every mom I know was touting the benefits of elderberry, or Sambucus nigra, which comes from the berries of a tree native to Europe, and is prepared in several ways, including pills, lozenges, syrups, and gummies. But I wasn't comfortable taking elderberry until I'd done my research.

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What do experts have to say? Elderberries do have some health benefits. "They have antibacterial, antiviral, and cytokines-producing properties, all of which boost the immune system," says Kecia Gaither, M.D., M.P.H., double board-certified in OB-GYN and maternal-fetal medicine. "This helps fight cold and flu viruses." Elderberries also have anti-inflammatory and antioxidant properties, are high in fiber, and can even help decrease "bad" cholesterol in the body, adds Dr. Gaither, who is also the director of perinatal services at NYC Health + Hospitals/Lincoln in New York.

But research is limited on the safety of elderberry in pregnancy. "There is not enough sufficient data on the use of elderberry during pregnancy or lactation," says Shuhan He, M.D., an emergency medicine physician at Massachusetts General Hospital and founder of ConductScience and Maze Engineers. "One study reported gastrointestinal (GI) distress in pregnant women taking elderberry. However, recognize that everybody's body reacts differently and many people experience no side effects at all."

It may be a safer option than some over-the-counter or prescription drugs, but that still doesn't guarantee it won't have adverse effects, says holistic wellness practitioner Audrey Christie, MSN, RN, CCMA. "There haven't been any adverse events reported with elderberry extract, but it is important to use caution," says Christie.

And be warned: Unripened elderberries are toxic and should be avoided, says. Dr. Gaither. The same goes for preparations made from the plant's bark, leaves, or flower, due to the risk of poisoning.

Elderberry Is Not FDA-Approved

Another big drawback: Elderberry is regulated as a supplement and is not a drug approved by the U.S. Food and Drug Administration (FDA). The FDA doesn't have to approve a supplement before it goes on sale, and it's up to the company that manufactures it to label it properly and ensure its safety. It's only after it's on the market that the FDA can deem a supplement unsafe.

That's why during pregnancy and even after, it's important to be a savvy consumer when purchasing and taking herbal supplements. Only buy from companies you trust and those that follow Good Manufacturing Practices (GMP), and it's best avoid purchasing homemade preparations.

So elderberry may not be the magical pregnancy cure-all you're looking for. Don't stress. Experts note other ways to stay healthy during pregnancy. "The foundational pieces of a good immune system no matter your age are sleep, plenty of whole plant food, stress mitigation, and getting vitamin D," says Christie.

And don't forget good old soap and water. "Keeping up good hand hygiene is key," notes Dr. He.

The Bottom Line

There isn't enough research to guarantee elderberry is safe to take during pregnancy. As with any supplement consumed during pregnancy, it's important to speak to your physician first.

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