Is Cascara Sagrada compatible with breastfeeding? Do we have alternatives for Cascara Sagrada?

Cascara Sagrada

August 19, 2017 (Low Risk)

The bush bark is used.
It contains anthraquinone (cascarosides) irritant, tannins and resins.
Unproven properties: laxative.
Indications according to Commission E of the German Ministry of Health: constipation, purge for pre-surgical and pre-exploration procedures.

According to old reports that are not well-documented, may be excreted into breast milk and can cause diarrhea in infants.

Other laxatives are considered safer like bulk forming ones, osmotic ones, emollient or lubricants. It is critical to follow a balanced and rich-in-fiber diet as well as an adequate fluid intake and routinely exercising.

The American Academy of Pediatrics: medication that is usually compatible with breastfeeding.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Bear wood
  • Bitter bark
  • Cascara buckthorn

Writings

  • Frangula purshiana (Latin, botanical name)
  • Rhamnus purshiana (Latin, botanical name)
  • Κασκάρα (Greek)

Drug trade names

References

  1. Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. Aliment Pharmacol Ther. 2013Abstract Full text (link to original source) Full text (in our servers)
  2. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  3. EMEA. Rhamnus purshianus Community herbal monographs. 2007 Full text (in our servers)
  4. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  5. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000Abstract
  6. WHO. World Health Organization. Geneva. WHO monographs on selected medicinal plants. Volume 2. WHO monographs. 1999 Full text (link to original source) Full text (in our servers)
  7. Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact. 1998Abstract
  8. Lewis JH, Weingold AB. The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol. 1985Abstract
  9. Knowles JA. Breast milk: a source of more than nutrition for the neonate. Clin Toxicol. 1974Abstract
  10. O'Brien TE. Excretion of drugs in human milk. Am J Hosp Pharm. 1974Abstract
  11. Greenleaf JO, Leonard HSD. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner 1973;210:259–63. 1973
  12. DUNCAN AS. Standardized senna as a laxative in the puerperium; a clinical assessment. Br Med J. 1957Abstract Full text (link to original source) Full text (in our servers)
  13. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I. Laxatives. J Pediatr 1937;11:824–32. 1937