by Donna Walls, RN, BSN, IBCLC, ANLC, Certified Aromatherapist, Master Herbalist

Aromatherapy can be as simple as feeling calm when you smell bread baking or feeling a sense of peacefulness when inhaling ocean breezes. Our discussion today will look at the therapeutic practice of using essential oils to affect mind and body. The essential oils are literally the plant oils distilled from aromatic plants. This concentrated oil can be used in many ways, but like the plants, must be used respectfully. Essential oils produce an aroma, most often pleasant, and thought of as medicinally benign. Just the opposite is true as these oils are 75-100 times more potent than the plant they are extracted from. These oils are distilled or expressed from the plant. Oils change in character depending on the part of the plant used, which can be from the flower, the leaf, the seed, the root, or the rind. For example, the oils from the orange peel (orange essential oil) are distinctly different from the oils from the orange leaves (petitgrain essential oil) or orange blossoms (neroli essential oil).

The Effects of Essential Oils on the Body

Essential oils enter the body through the nose or the skin. Once inhaled the sense of smell is carried directly to the limbic area of the brain; the seat of emotions, memory and some regulatory functions. Most aromas evoke memories, some are good and others may be unpleasant, making the need to individualize their use an important aspect of aromatherapy. Although we can make some generalizations such as the relaxing effect of lavender, individuals may vary in their responses to the essential oils.

Choosing Essential Oils

The therapeutic effects of essential oils are well documented, but these effects are derived only from actual plant oils. Synthetic oils may have a pleasant aroma, but do not demonstrate the same therapeutic effect on mind and body. Synthetics are often labeled “perfume” or “fragrance” oils. When selecting and using essential oils, choose only a “pure essential oil” which is stored in dark amber bottles. Pure essential oils most often are more expensive, have a fuller, deeper aroma, and evaporate quickly when placed on paper.

Methods of Administering

• Diffusers: Electric, battery, lamp rings
• Water Therapies: 10-20 drops in a tub bath or for hydrotherapy in labor or 5-10 drops in a sitz or foot bath
• Steams: Especially for inhalation therapy
• Massage Oils: 1 oz carrier oil to 15-30 drops of essential oil (single or total number); For pregnancy the recommendation is 12-20 drops in 1 oz)
• Misters: To mix the essential oil in water (15-30 drops for each ounce of water) – add a  small amount of witch hazel or Vodka to disperse the oils in water. This helps mix the oil and water but is not necessary
• In or on lockets or jewelry
• With Salts: Good carriers for bath or inhalation remedies, add a small amount of drops to the jar containing table or specialized salts
• Add 2-5 drops to soaps, shampoos, detergents
• As a mouthwash with distilled water (15-30 drops per ounce of water)
• Aroma stones or cotton balls
• Added to vaporizers or humidifiers
• Topical application to the skin provides an efficient means of delivering the therapeutic actions. Essential oils, because of their natural concentration, must be diluted with a carrier or base oil before application. There are two exceptions to this rule, lavender and tea tree essential oils can be applied “neat” or undiluted to the skin.

Carrier, or base, oils are organic, cold pressed oils from seeds, nuts or vegetables. Avoid using petroleum based oils such as mineral or “baby” oil as a carrier oil. Some well absorbed carrier oils are: Wheat germ, sweet almond, apricot kernel, grapeseed, olive, canola, castor, hazelnut, rose hip, sesame, safflower, sunflower, coconut, or walnut.

Dilutions for Topical Use

Most healthy adults will use the 4% dilution for most topical applications. Pregnant women should use the 2% or lower range of 4% dilutions with children and health compromised adults using a 1% dilution. Number of drops is for 1 oil or a total combination of oils.

Some general safety guidelines for use in pregnancy and breastfeeding are:

• Do not use oils undiluted on the skin- do a patch test if prone to sensitivities
• Discontinue essential oils if headache, rash or nausea begins
• DO NOT take oils internally. Our bodies are not designed to utilize food or medicines that are so highly concentrated and can cause damage to the liver and kidneys. Oral use can be dangerous and there is no added benefit over inhalation or application to the skin.
• Use only in small amounts- formulas for essential oils are given in drops only, do not exceed recommended number of drops.
• Do not use in or near eyes.
• Use only pure essential oils.
• Use only the topical application dilution recommended for pregnancy.
• Use extra care on broken or damaged skin.
• Use only approved oils for breastfeeding, pregnancy, infants and children.

Essential oils to Avoid throughout Pregnancy, Labor, and while Breastfeeding

Table reprinted from National Association for Holistic Aromatherapy Avoid during breastfeeding: add peppermint and sage

Oils Generally Regarded as Safe

• Lavender
• Chamomile
• Patchouli
• Sandalwood
• Rosemary
• Eucalyptus
• Neroli
• Marjoram
• Cedarwood
• Citrus (in small doses)
• Jasmine
• Ylang ylang
• Bergamot
• Fennel (small amounts)
• Rose geranium
• Tea tree
• Rose
• Cypress
• Peppermint {safe in pregnancy, avoid during breastfeeding)

Remember, the use of essential oils should be individualized, each person has unique responses to the oils. Aromatherapy can be an important part of holistic care, but must be used as part of an evidenced-based  program.

References and Resources

https://www.naha.org alliance-aromatherapists.org/aromatherapy/aromatherapy-safety/#internal http://kaylafioravanti.com/fda-action-doterra-young-living/ http://www.aromaweb.com/articles/safety.asp http://www.alliance-aromatherapists.org/aromatherapy/aromatherapy-safety/ Conrad, Pam. Women’s Health Aromatherapy. 2019. Singing Dragon Publishing. Vancouver, British Columbia https://www.thearomablog.com/benefits-of-essential-oils/ Peterfalvi A, Miko E, Nagy T, Reger B, Simon D, Miseta A, Czéh B, Szereday L. Much More Than a Pleasant Scent: A Review on Essential Oils Supporting the Immune System.Molecules. 2019 Dec 11;24(24). pii: E4530. doi: 10.3390/molecules24244530. Review.PMID:31835699 Koh LM, Percival B, Pauley T, Pathak S. Complementary therapy and alternative medicine: effects on induction of labour and pregnancy outcome in low risk post-dates women.Heliyon. 2019 Nov 22;5(11):e02787. doi: 10.1016/j.heliyon.2019.e02787. eCollection 2019 Nov.PMID:31799460 Deyno S, Mtewa AG, Abebe A, Hymete A, Makonnen E, Bazira J, Alele PE. Essential oils as topical anti-infective agents: A systematic review and meta-analysis. Complement Ther Med. 2019 Dec;47:102224. doi: 10.1016/j.ctim.2019.102224. Epub 2019 Oct 24. Review.PMID:31780027 Abbasijahromi A, Hojati H, Nikooei S, Jahromi HK, Dowlatkhah HR, Zarean V, Farzaneh M, Kalavani A. Compare the effect of aromatherapy using lavender and Damask rose essential oils on the level of anxiety and severity of pain following C-section: A double-blinded randomized clinical trial. J Complement Integr Med. 2019 Nov 15. pii: /j/jcim.ahead-of-print/jcim-2019-0141/jcim-2019-0141.xml. doi: 10.1515/jcim-2019-0141. [Epub ahead of print] PMID:31730539 Koh LM, Percival B, Pauley T, Pathak S. Complementary therapy and alternative medicine: effects on induction of labour and pregnancy outcome in low risk post-dates women. Heliyon. 2019 Nov 22;5(11):e02787. doi: 10.1016/j.heliyon.2019.e02787. eCollection 2019 Nov. PMID:31799460 Chen SF, Wang CH, Chan PT, Chiang HW, Hu TM, Tam KW, Loh EW. Labour pain control by aromatherapy: A meta-analysis of randomised controlled trials. Women Birth. 2019 Aug;32(4):327-335. doi: 10.1016/j.wombi.2018.09.010. Epub 2018 Oct 19. PMID:30344029 Ozgoli G, Saei Ghare Naz M. Effects of Complementary Medicine on Nausea and Vomiting in Pregnancy: A Systematic Review. Int J Prev Med. 2018 Aug 30;9:75. doi: 10.4103/ijpvm.IJPVM_430_16. eCollection 2018. Review. PMID:30319738 Kianpour M, Moshirenia F, Kheirabadi G, Asghari G, Dehghani A, Dehghani-Tafti A. The Effects of Inhalation Aromatherapy with Rose and Lavender at Week 38 and Postpartum Period on Postpartum Depression in High-risk Women Referred to Selected Health Centers of Yazd, Iran in 2015. Iran J Nurs Midwifery Res. 2018 Sep-Oct;23(5):395-401. doi: 10.4103/ijnmr.IJNMR_116_16. PMID:30186346