Preferred choice

Ispaghula husk can be used during breastfeeding.

Infant monitoring

No specific infant monitoring is usually required.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Although there is no evidence for use in breastfeeding, ispaghula husk is not absorbed by the body and will not appear in breast milk. Infant side effects are therefore not expected.

Ispaghula husk can be used in infants over 1 month old.  Doses used will be much higher than the amounts the infant may be exposed to via breast milk.

Preferred choice

Lactulose can be used during breastfeeding.

Infant monitoring

As a precaution monitor the infant for diarrhoea, vomiting or irritability.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Although there is no evidence for use in breastfeeding, its very low oral bioavailability makes passage into breast milk highly unlikely. Infant side effects are therefore not expected.

Lactulose can be used in infants over 1 month old.  Doses used will be much higher than the amounts the infant may be exposed to via breast milk.

Preferred choice

Macrogol 3350 can be used during breastfeeding.

Infant monitoring

As a precaution monitor the infant for diarrhoea, vomiting or irritability.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Although there is no evidence for use in breastfeeding, its negligible oral bioavailability and high molecular weight will limit passage into breast milk and absorption by the infant. Infant side effects are therefore not expected.

Preferred choice

Sodium citrate enemas can be used during breastfeeding.

Infant monitoring

No specific infant monitoring is usually required.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Although there is no evidence for use in breastfeeding passage into breast milk is expected to be insignificant due to minimal systemic rectal absorption. Any that is absorbed is metabolised to bicarbonate. Both sodium and bicarbonate are found naturally in breast milk. Infant side effects are therefore not expected.

Preferred choice

Bisacodyl can be used during breastfeeding.

Infant monitoring

As a precaution monitor the infant for diarrhoea or irritability.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Bisacodyl is poorly absorbed from both oral or rectal formulations and is converted to an active metabolite.

Very limited evidence suggest that the active metabolite is not detected in breast milk.  Any bisocodyl or active metabolite that could be present in breastmilk would also be poorly absorbed by the infant.  Infant side effects are therefore not expected.

Preferred choice

Docusate can be used during breastfeeding.

Infant monitoring

No specific infant monitoring is usually required.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Although there is no evidence for use in breastfeeding, its low oral bioavailability will limit passage into breast milk and absorption by the infant. Infant side effects are therefore not expected.

Preferred choice

Glycerol suppositories can be used during breastfeeding.

Infant monitoring

No specific infant monitoring is usually required.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Although there is no evidence for use in breastfeeding, its negligible rectal bioavailability will limit passage into breast milk.

Glycerol is found naturally in breast milk, and infant side effects are therefore not expected.

Glycerol suppositories can be used in infants.  Doses used will be much higher than the amounts the infant may be exposed to via breast milk.

Preferred choice

Standardised senna preparations can be used during breastfeeding.

Infant monitoring

As a precaution monitor the infant for diarrhoea or irritability.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Limited published evidence has shown negligible amounts in breast milk, due to its poor oral absorption and high molecular weight. No side effects have been reported in breastfed infants.

Non-standardised senna preparations are available to purchase as herbal or alternative products.  The ingredients or potency in these products may vary and patients should be advised that standardised products should be used.

Senna can be used in infants over 1 month old.  Doses used will be much higher than the amounts the infant may be exposed to via breast milk.

Preferred choice

Sodium picosulfate can be used in breastfeeding.

Infant monitoring

As a precaution monitor the infant for diarrhoea or irritability

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Sodium picosulfate has low oral bioavailability and is converted to an active metabolite. Very limited evidence suggests that the active metabolite is not detected in breast milk. Infant side effects are therefore not expected.

Sodium picosulfate can be used in infants over 1 month old.  Doses used will be much higher than the amounts the infant may be exposed to via breast milk.

Use with caution

Prucalopride can be used in breastfeeding with caution.  Other types of laxatives are preferable but, given its place in therapy, may already have been tried.

Infant monitoring

As a precaution, monitor the infant for diarrhoea vomiting, drowsiness, irritability, poor feeding or adequate weight gain.

Monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine.

Further information

Very limited data indicate small levels in breast milk.

Although there is no published evidence of infant levels, side effects are unlikely.