Buckthorn use while Breastfeeding
Medically reviewed on April 11, 2017.
Buckthorn Levels and Effects while Breastfeeding
Summary of Use during Lactation
The bark, stems and leaves of European buckthorn (Rhamnus catharticus), alder buckthorn (Rhamnus frangula) and California buckthorn (Rhamnus purshiana) contain anthraquinones that have potent cathartic properties. (Do not confuse these products with sea buckthorn [Hippophae rhamnoides]). Maternal intake of the cathartic buckthorn products might cause loose stools in breastfed infants and their use should be avoided.
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No published information was found as of the revision date on European buckthorn or alder buckthorn. However, the chemical constituents of these products is similar to that of cascara sagrada (California buckthorn).
Maternal Levels. After administration of 65 mg of cascara sagrada as cascara fluidextract, cascara was qualitatively detected in the breastmilk of 5 of 10 women collected over 20 hours. The sensitivity of the assay was about 1100 mg/L of cascara.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
In 2 uncontrolled studies, a total of 10 of 22 breastfed infants appeared to have loose stools after administration of 65 mg of cascara as cascara fluidextract to their mothers.
No cases of diarrhea were observed among the breastfed infants of 142 mothers who received 400 mg of cascara extract on day 3 postpartum.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
1. Lewis JH, Weingold AB and the Committee of FDA-Related Matters, American College of Gastroenterology. The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol. 1985;80:912-23. PMID: 2864852
2. Nice F, Coghlan RJ, Birmingham BT. Which herbals are safe to take while breastfeeding? Here's a guide to popular herbs and their potential risk to nurslings. US Pharm. 2000;25.
3. Hardy ML. Women's health series: herbs of special interest to women. J Am Pharm Assoc (Wash). 2000;40:234-42. PMID: 10730024
4. Kopec K. Herbal medications and breastfeeding. J Hum Lact. 1999;15:157-61. PMID: 10578793
5. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I: Laxatives. J Pediatr. 1937;11:824-32.
6. Duncan AS. Standardized senna as a laxative in the puerperium. A clinical assessment. Br Med J. 1957;1:439-41. PMID: 13396280
Rhamnus catharticus Rhamnus frangula Rhamnus purshiana
LactMed Record Number
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