Kratom
Everyday exposureAlcohol, tobacco & drugsAlso called · 6 names▾▴
Mitragyna speciosa, kratom tea, kratom leaves, kratom powder, kratom for pain, kratom withdrawal
Recreational substance
General information · effects depend on amount, timing, and how it is used. About these sources
- Tea
Research strength: 2 / 5
The FDA warns consumers not to use kratom because serious adverse effects include liver problems, seizures, and substance use disorder. The FDA and LactMed report newborn withdrawal after kratom exposure during pregnancy, with cases requiring treatment. A 2021 review describes case reports, which cannot show how often withdrawal occurs. NIDA says pregnancy effects are not well understood and that other substances in reports make kratom's role hard to isolate. The case reports do not provide a first-trimester risk estimate. Ask your provider about your situation.
Last reviewed: 2026-10-16
Research strength: 2 / 5
The FDA warns consumers not to use kratom because serious adverse effects include liver problems, seizures, and substance use disorder. The FDA and LactMed report newborn withdrawal after kratom exposure during pregnancy, with cases requiring treatment. A 2021 review describes case reports, which cannot show how often withdrawal occurs. NIDA says pregnancy effects are not well understood and that other substances in reports make kratom's role hard to isolate. The case reports do not provide a second-trimester risk estimate. Ask your provider about your situation.
Last reviewed: 2026-10-16
Research strength: 2 / 5
The FDA warns consumers not to use kratom because serious adverse effects include liver problems, seizures, and substance use disorder. The FDA and LactMed report newborn withdrawal after kratom exposure during pregnancy, with cases requiring treatment. A 2021 review describes case reports, which cannot show how often withdrawal occurs. NIDA says pregnancy effects are not well understood and that other substances in reports make kratom's role hard to isolate. The case reports do not provide a third-trimester risk estimate. Ask your provider about your situation.
Last reviewed: 2026-10-16
Kratom — Breastfeeding
Research strength: 1 / 5
The FDA warns consumers not to use kratom because serious adverse effects include liver problems, seizures, and substance use disorder. LactMed says nursing mothers should generally avoid kratom because infant effects from several brain-acting substances in milk are unknown. LactMed found no relevant maternal milk or infant level information. A 2023 survey of 80 pregnant and postpartum people with substance use disorder had one person report kratom use during lactation, but it did not measure infant exposure or outcomes. LactMed says breastfeeding might lessen some newborn withdrawal signs, but it cannot replace direct treatment; the reports followed exposure during pregnancy. Ask your provider about your situation.
Last reviewed: 2026-10-16
Pregnancy
Human pregnancy evidence is limited to case reports and small surveys, with no reliable trimester-specific rate. Wright et al. (2021) reviewed five published reports involving six mothers; the article abstract instead says six case reports. Its full text says five of six infants had neonatal withdrawal signs and five received medication. It reports two cases with no other substances identified besides kratom, while several reports included other medicines or substances. The case reports cannot provide a pregnancy-wide incidence estimate or establish whether trimester, dose, or product strength changes the outcome. A 2023 case report described a term newborn with severe neonatal abstinence syndrome after daily maternal kratom use; mitragynine was confirmed in the newborn's serum and phenobarbital was used. NIDA says pregnancy effects are not well understood. The sources reviewed do not provide reliable human estimates for miscarriage or birth defects.
Breastfeeding
LactMed's December 15, 2025 review found no relevant published maternal milk levels, infant levels, or information on effects on lactation and breastmilk. Wright et al. (2021) identified the amount of kratom in breast milk and transfer to infants as areas needing research. A 2023 single-clinic survey of 80 pregnant and postpartum people with substance use disorder found one person who reported kratom use during lactation; the survey measured self-reported use and reasons, not milk concentrations or infant effects. Published newborn withdrawal cases followed prenatal exposure, sometimes alongside other substances and postpartum treatments, so they do not establish effects from kratom exposure through milk. LactMed says breastfeeding might lessen some newborn withdrawal signs in limited reports, but should not replace direct treatment of a withdrawing infant.
Kratom is the plant Mitragyna speciosa and products made from its leaves. The best-studied compounds are mitragynine and 7-hydroxymitragynine, which interact with opioid receptors. Products include leaf powder, tea, capsules, and concentrated extracts. NIDA reports that product effects may vary with concentration, formulation, route, other substances, and individual factors; some products have been found with contaminants.
What was tested
The 2021 systematic review searched PubMed, Cochrane Review, CINAHL, EBSCOhost, and Google Scholar and summarized five published case reports involving six mothers. It reported newborn withdrawal signs in five of six infants in those selected reports, but the case set has no denominator of all exposed pregnancies and does not estimate incidence. A 2023 case report described one term newborn and confirmed mitragynine in the newborn's serum. A 2023 anonymous survey included 80 patients at one clinic; four reported kratom use during pregnancy and one reported use during lactation. No milk or infant concentration study was identified by LactMed as of its December 2025 revision. No controlled pregnancy safety trials or trimester-specific outcome studies were identified in the sources reviewed.
How to interpret FDA's consumer warning alongside the WHO ECDD's international-control review
- Source A says
- The FDA warns consumers not to use kratom because serious adverse effects include liver problems, seizures, and substance use disorder, and reports newborn withdrawal after prolonged prenatal exposure. (FDA: FDA and Kratom, LactMed: Kratom)
- Source B says
- The WHO ECDD concluded that evidence was insufficient to recommend a critical review of kratom and recommended continued surveillance of kratom and its main alkaloids. (WHO Expert Committee on Drug Dependence: Kratom pre-review)
- Why they differ
- These are different policy questions. The FDA's warning addresses consumer health risks and product marketing in the United States. The WHO ECDD decision addresses whether the evidence justified a full critical review or international control. The WHO report also records liver events and newborn withdrawal reports, so its surveillance recommendation is not a pregnancy-use endorsement.
- What the evidence shows overall
- The FDA's warning not to use kratom should be stated plainly. The WHO ECDD's surveillance decision does not negate the FDA warning or the reported newborn withdrawal cases. Human pregnancy reports remain case-based and do not establish frequency or trimester-specific risk, and direct infant milk exposure data are absent.
- The FDA warns consumers not to use kratom because of the risk of serious adverse events, including liver problems, seizures, and substance use disorder. (FDA)
- LactMed says nursing mothers should generally avoid kratom because infant health effects from substances in breast milk are unknown. (LactMed)
- The FDA encourages consumers and health professionals to report suspected adverse reactions through MedWatch or the Safety Reporting Portal. (FDA)
General research, not specific to pregnancy.
The FDA warns consumers not to use kratom because of serious adverse-event risks. FDA warnings include a 2024 alert for one named liquid kratom product and a separate 2025 action focused on concentrated 7-OH products, which the FDA distinguishes from natural kratom leaf.
- The FDA lists serious adverse events that include liver problems, seizures, and substance use disorder; it says deaths are rare and usually involve other drugs, with kratom's contribution unclear. (FDA: FDA and Kratom)
- On July 26, 2024, the FDA advised consumers not to consume OPMS Black Liquid Kratom after reports of serious adverse events, including a death. This alert names that product and should not be read as a product-specific finding about every kratom preparation. (FDA Safety Alert: OPMS Black Liquid Kratom)
- In July 2025, the FDA recommended scheduling action for certain concentrated 7-OH products and said the action was not focused on natural kratom leaf products; the DEA retained final scheduling authority at the time of the announcement. (FDA: July 2025 action on concentrated 7-OH products)
- A May 2026 case report described seizure-like activity and a life-threatening heart rhythm after a young woman ingested a highly concentrated kratom extract. This single case does not establish frequency or pregnancy-specific effects. (McLin-Evans et al., 2026 case report of ventricular tachycardia after kratom extract)
- FDA: FDA and KratomUS governmentSecondaryPage dated 2025-12-02
- FDA Safety Alert: OPMS Black Liquid KratomUS governmentSecondaryPage dated 2024-07-26
- FDA: July 2025 action on concentrated 7-OH productsUS governmentSecondaryPage dated 2025-07-29
- LactMed: KratomUS governmentSecondaryPage dated 2025-12-15
- NIDA: KratomSecondaryPage dated 2026-03-11
- NCCIH: KratomUS governmentSecondary
- WHO Expert Committee on Drug Dependence: Kratom pre-reviewSecondaryPage dated 2023-04-25Independent check
- Wright et al., Journal of Perinatology 2021: systematic review of prenatal kratom exposureUS governmentPrimaryPage dated 2021-09-28Independent check
- Leferink et al., 2023 case report of neonatal abstinence after maternal kratom useUS governmentPrimaryPage dated 2023-09-28Independent check
- Bowman et al., Journal of Addiction Medicine 2023: peripartum kratom use surveyUS governmentPrimaryPage dated 2023-08-22Independent check
- Jones et al., Obstetrics & Gynecology 2025: emerging substances and perinatal health reviewUS governmentPrimaryPage dated 2025-10-30
- Hardy et al., Journal of Midwifery & Women's Health 2026: perinatal kratom use disorder articlePrimaryPage dated 2026-08-11
- McLin-Evans et al., 2026 case report of ventricular tachycardia after kratom extractUS governmentPrimaryIndependent check
Last reviewed 2026-10-16
Independent check 2026-10-16
Not yet clinician-reviewed
Ask your provider about your situation.