Calendula and Sore Nipples While Breastfeeding: What Is Known

No trial has tested calendula on its own for sore or cracked nipples, and the EU herbal medicines committee advises against calendula preparations during breastfeeding because safety data are missing. That does not mean a mother who has already decided to try a calendula salve is doing something reckless, but it does mean the usual "calendula salve for nursing" advice rests on very little. We make a plain infused calendula oil, and this is what we would want a nursing parent to know before putting any calendula product where a baby will feed.

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Why the pain is the first problem to solve

A salve is a surface layer, and nipple pain usually has a cause underneath it. A clinic audit of 1,177 consultations at the Breast Feeding Centre of Western Australia (2011 and 2014) found nipple pain was a reason for the visit in 36% of cases. The most common attributed cause was incorrect positioning and attachment, followed by tongue tie, infection, palatal anomaly, flat or inverted nipples, mastitis and vasospasm; pain was resolving or resolved in 57% of cases after 18 days (range 2-110), and the advice given included correcting positioning and attachment, nipple shields, resting the nipples, frenotomy, antibiotics and topical products (Kent et al., Int J Environ Res Public Health, 2015). Reasoning from that, putting calendula over a poor latch or an infection addresses nothing underneath, and delays the visit that would. A lactation consultant, midwife or physician is the right first call; so is a pediatrician if the baby's mouth or feeding looks involved.

Two systematic reviews of the evidence on topical options are worth knowing. A 2014 Cochrane review of four good-quality trials (656 women) tested glycerine pads, lanolin with breast shells, lanolin alone, expressed breast milk and an all-purpose nipple ointment; none of those interventions was calendula, and it found no benefit on pain from glycerine gel dressings or lanolin with breast shells (Dennis et al., Cochrane Database Syst Rev, 2014). A 2018 review of nipple-pain trials named menthol, warm compresses and teaching correct technique as reported effective, and some herbs such as aloe vera and purslane; calendula does not appear in its abstract (Niazi et al., J Pharmacopuncture, 2018).

What the calendula record contains

NIH's LactMed database says topical calendula "has been used" on sore nipples while nursing "although little high-quality evidence supports this use." Its examples are a cream combining Mimosa tenuiflora and calendula in an uncontrolled case series, which it says makes judging calendula's contribution "impossible," and a calendula-echinacea combination that outperformed breast milk in "a study of modest quality" (LactMed, Calendula, 2021 revision). Both involve a second ingredient, so neither tells you what calendula did. LactMed also says there is no information on oral calendula during breastfeeding, and that allergic reactions, including cross-reactions to chrysanthemums, daisies and marigolds, "occur rarely."

The advisory bodies are cautious but not identical. The EU monograph says safety in pregnancy and lactation "has not been established" and recommends against use "in the absence of sufficient data" (EMA/HMPC, 2018). The EU assessment report notes that an earlier reference, ESCOP 2003, had "no objections to external use during pregnancy and lactation" but no data to confirm safety (EMA/HMPC assessment report, 2018). Memorial Sloan Kettering's herb page, written for cancer patients, advises against calendula while pregnant or breastfeeding because safety data are lacking (MSK, About Herbs, 2023). None of these reports harm; all report absence of data, and they differ only in how strongly they say to avoid it.

The part specific to nipples: the baby is the second user

Anything on the nipple ends up in an infant's mouth, so two things from the sources matter. First, the EU monograph states use of skin preparations in children under 6 has not been established due to lack of adequate data, and nothing we found addresses infant ingestion of calendula. Second, carrier oil matters: the EU assessment report advises against peanut oil as the extraction oil "because of the higher probability of adverse reactions." We do not name our carrier on this site; it is listed on the batch paperwork, and you can request it by emailing the lot number to [email protected]. For any product intended near a nursing infant, we would want the carrier named before the first use, from any supplier. Our broader article on pregnancy and postpartum use covers the same evidence from another angle.

If you and your clinician decide to try one anyway

This is reasoning from the sources, not a protocol:

  1. Get the cause looked at first. Positioning, attachment, tongue tie, thrush and vasospasm each have a different answer, and a lactation consultant can tell them apart.
  2. Rule out the allergy. If you react to chamomile, ragweed, daisies or chrysanthemums, skip calendula; the EU monograph lists daisy-family hypersensitivity as a contraindication. Test on your forearm first; dermatologists who run repeated-application tests most often apply twice daily for one to two weeks, though no standard method exists (Brown et al., Dermatitis, 2015). Our patch test article explains the short version.
  3. Use a product with calendula and a named carrier only. Avoid essential oils, fragrance and added herbs. The sources we have on essential-oil dilution are written for adults and for young children's skin, not for oil a baby will swallow.
  4. Stop if anything gets worse. FDA's advice for any cosmetic is to stop the product, contact a healthcare provider and report the reaction (FDA, Using Cosmetics Safely).

A note on making your own salve

A common starting ratio for a general-purpose salve is about 1 part beeswax to 4 parts infused oil in the recipe's own units, adjusted softer or firmer, melted gently and poured into a tin (Mountain Rose Herbs). We give that ratio for general use only. We found no source stating a concentration of calendula or a recipe that has been evaluated for use on nursing nipples, and the EU concentrations (2-8% herbal substance equivalent in semi-solids) describe licensed products for people over 6, not nursing mothers. FDA notes that making cosmetics at home is not illegal but the maker is responsible for safety (FDA, small businesses and homemade cosmetics). Our first aid salve article covers the method; it is not a nipple recipe.

When to stop reading and call someone

Call a lactation consultant, midwife or physician if the pain is not resolving, or if you suspect infection or mastitis. These are the situations the Western Australian audit lists as causes: infection, mastitis and vasospasm, all of which need a clinician's diagnosis and not a salve.

If you are not nursing and just want a plain infused oil, our calendula oil is a plain infused oil with batch documentation on request, but for sore nipples while breastfeeding, we would send you to a lactation consultant first.

Calendula oil bottle

Calendula Oil

Nature's Golden Botanical, bottled: small-batch calendula oil in sizes from 0.5 oz to bulk.

From $13.99

Shop Calendula Oil →

Sources & Further Reading