Sage Oil in Pregnancy and Breastfeeding: What Authorities Say
There is no dilution table and no "allowed" list in this article, on purpose. Our process page says to avoid sage oil entirely during pregnancy and while breastfeeding, and every authority we could read points the same way or says it does not know. What follows is exactly what each source covers, since most of them are about sage tea, leaf or extracts, not the oil, and the difference changes what the sentence means.
What each source says, and about what
| Source and date | Material it covers | What it says |
|---|---|---|
| EMA herbal committee assessment report, 2016 | Sage leaf preparations and sage oil | Sage is contraindicated in pregnancy and lactation, citing ESCOP 2003 and Barnes 2002 and 2007; the assessor adds that use in pregnancy and lactation "is not recommended" and that there are no fertility data |
| EMA thujone statement, 2012 | Thujone-containing herbal medicines | No studies allow a reliable assessment for pregnant women and children, so use "should be minimised" |
| NCCIH, April 2025 | Sage (herb, supplements) | "It may be unsafe to use sage during pregnancy because its component thujone may have harmful effects"; "Little is known about whether it's safe to use sage while breastfeeding" |
| LactMed (NIH), revised 15 July 2025 | Sage | "No data exist on the safety of sage in nursing mothers or infants"; thujone and camphor "are both neurotoxic in high doses" |
| MotherToBaby, 1 April 2025 | Herbal products in general | "Most herbal products have not been well studied during pregnancy"; does not mention sage |
Sources: EMA/HMPC, 2016; EMA/HMPC, 2012; NCCIH, 2025; LactMed, 2025; MotherToBaby, 2025.
How strong is the evidence behind the warnings?
Weaker than the confident wording suggests, and that is worth saying plainly. The EMA's assessment report repeats, from the reference books it cites (Barnes 2002 and 2007), that the thujones in the oil are abortifacient and emmenagogic; the EMA assessor's own comment is that safety in pregnancy "has not been established" and that "in the absence of sufficient data" use is not recommended. Elsewhere the same report says there is no information on reproductive and developmental toxicity. So the warning rests on reference works and on thujone's known neurotoxicity (see the thujone article), not on a trial in pregnant people, and no such trial exists in the sources we read. A ban without a trial is a precaution, not a measured risk, and the right response to a precaution about a pregnancy is to follow it.
We also did not find a Tisserand or NAHA statement on sage that we could verify. The Tisserand Institute's general guidance says to get advice before using essential oils if you are pregnant or have epilepsy (Tisserand Institute).
Oil, tea and leaf are different exposures
NCCIH and LactMed are about the plant as a herb or supplement. The EMA's 6.0 mg per day thujone limit, which comes from the oral herbal medicine context, applies to sage leaf preparations and not to the oil (EMA/HMPC, 2016 statement). For the oil the EMA found a negative benefit-risk balance and described it as a moderate skin irritant not recommended for aromatherapy. A pregnant person who reads that sage tea is "an herb" and concludes the oil is similar has the direction right and the scale wrong: our arithmetic in the thujone article shows one drop of an oil resembling the batches EFSA analysed would carry more thujone than the 6.0 mg daily figure. We did not find any source that measures thujone absorbed through skin or lungs from the oil in pregnant people.
Sage and milk supply
People ask this because sage has a traditional reputation for drying up milk. LactMed's wording is that sage and Greek sage "purportedly reduce lactation and have been used to aid with weaning or an overabundant milk supply", followed by: "No scientific studies could be located that evaluate the effect of sage on the milk supply." So the reputation is traditional, not tested, and the same entry says nothing is known about safety for nursing mothers or infants. If your supply is a concern, or you want to wean, that conversation belongs with a lactation consultant, midwife or physician. We sell no product for lactation and make no claim about it. A nursing parent also has an infant in the room, and our guidance about children applies: see the children article.
What about sage in the air
The sources we read include no study of sage oil vapour in pregnant or breastfeeding people. Our process page tells you to avoid the oil entirely in both situations, and we hold to that for diffusing, for soap, candle and perfume making where you handle the oil in quantity, and for blends made by someone else in your home. The reasoning is limited to what the sources support: thujone is neurotoxic, the data for pregnancy do not exist, and the cost of choosing another scent for nine months is low. If you work with the oil professionally, bring the product name and any composition information to your obstetric clinician or midwife; the question to ask is whether your handling is acceptable, which is a judgement we cannot make for you. If you want a thujone figure to take with you, ask the supplier for it in writing; our certificate does not carry one.
If you have already used it
Stop using it, and write down what you used before you call anyone: the product name and size, whether it was neat, diluted (and to what percentage) or diffused, how often, for how long, and when you last used it. That is what a clinician or poison centre needs, and it is more useful than a general question. Poison Help (1-800-222-1222) takes calls about swallowed oil and spills. For skin or air exposure with no symptoms, the question for your obstetric clinician is whether any follow-up is wanted; we cannot say, and none of the sources we read gives a number that would let us. Nothing in this article should be read as saying that earlier use caused harm. The sources say the data are missing, not that harm has been shown at low exposure.
Who to ask
- An obstetric clinician or midwife for any decision about a herbal or aroma product during pregnancy.
- A pharmacist or lactation consultant while breastfeeding.
- MotherToBaby for questions about exposures in pregnancy and lactation; its herbal products sheet is the general reference above.
- Poison Help, 1-800-222-1222, if the oil was swallowed or a large spill occurred.
If the claims you have read online say sage oil is "natural" and therefore fine in pregnancy, see the myths article; for the household rules around any sage bottle, our safety basics still apply.
Our position is simple and does not depend on the studies being finished: if you are pregnant or breastfeeding, leave sage oil on the shelf and ask your clinician before using anything that contains it.
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Shop Now →Sources & Further Reading
- EMA/HMPC, 2016. Assessment report on Salvia officinalis L., folium and aetheroleum (EMA/HMPC/150801/2015). ema.europa.eu
- EMA/HMPC, 2016. Public statement on Salvia officinalis L., aetheroleum (EMA/HMPC/41843/2009 Corr.1). ema.europa.eu
- EMA/HMPC, 2012. Public statement on the use of herbal medicinal products containing thujone, Rev. 1. ema.europa.eu
- NCCIH, 2025. Sage. nccih.nih.gov/health/sage
- NIH, 2025. Sage. In: Drugs and Lactation Database (LactMed). pubmed/30000875
- MotherToBaby, 2025. Herbal products and pregnancy. mothertobaby.org
- Tisserand Institute. Safety guidelines. tisserandinstitute.org