Multiple studies of senna preparations that belong to the anthraquinone family, and which used to be considered contraindicated, have shown that the risk of causing diarrhea in breastfed infants is apparently quite low (survey by Bennett 1996).
Bulking agents such as linseed and wheat bran are not absorbed. Bisacodyl and osmotic agents such as lactulose, or saline agents such as sodium sulfate, are also scarcely absorbed. Although there is no documented experience available on macrogol, it seems acceptable because of low intestinal resorption.
The inhibition of the absorption of fat-soluble vitamins with castor oil, and the possible drastic action of sodium picosulfate, argue against their use.
Recommendation. If a change in dietary habits is not successful, bulking agents, senna preparations, bisacodyl, and both saline and osmotic agents may be taken during breastfeeding. Changing the intestinal flora with bacterial cultures is also permissible.
A single administration of another laxative does not require any limitation of breastfeeding, but use of the laxative should be stopped.
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