Last update: Aug. 19, 2017

Bitter bark

Low Risk for breastfeeding


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

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

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

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Other names

Bitter bark is also known as Cascara Sagrada. Here it is a list of alternative known names::


Bitter bark in other languages or writings:

Groups

Bitter bark belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Bitter bark in its composition:

  • Doce Alivio™. Contains other elements than Bitter bark in its composition
  • Fave De Fuca™. Contains other elements than Bitter bark in its composition
  • Gastricur™. Contains other elements than Bitter bark in its composition
  • Linoforce™. Contains other elements than Bitter bark in its composition
  • Linomed™. Contains other elements than Bitter bark in its composition

References

  1. Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. Aliment Pharmacol Ther. 2013 Abstract 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. 2011 Sep;40(9):684-90. Review. Abstract 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. MSC - Ministerio de Sanidad y Consumo de España. ORDEN SCO/190/2004, de 28 de enero, por la que se establece la lista de plantas cuya venta al público queda prohibida o restringida por razón de su toxicidad. BOE 2004; 32:5061-6065 Full text (link to original source) Full text (in our servers)
  5. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  6. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000 Nov;16(4):319-31. Review. Erratum in: J Hum Lact 2001 Feb;17(1):90. Abstract
  7. 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)
  8. Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact. 1998 Sep;14(3):259-62. Review. Abstract
  9. Knowles JA. Breast milk: a source of more than nutrition for the neonate. Clin Toxicol. 1974 Abstract
  10. O'Brien TE. Excretion of drugs in human milk. Am J Hosp Pharm. 1974 Sep;31(9):844-54. Review. Abstract
  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. 1957 Abstract 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

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