Cascara Sagrada

Drug Levels and Effects:

Summary of Use during Lactation:

Maternal cascara intake might cause loose stools in some breastfed infants and should be avoided.[1] Other laxatives are preferred.

Drug 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.[2] 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 neonates appeared to have loose stools after administration of 65 mg of cascara as cascara fluidextract to their mothers.[2]

In an observational case series, no cases of diarrhea were observed among the breastfed infants of 142 mothers who received 400 mg of cascara extract on day 3 postpartum.[3] This result might have been because of the small amount of colostrum received by the infants of this age.

Possible Effects on Lactation:

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider:

Bisacodyl,Magnesium Hydroxide,Senna


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. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I: laxatives. J Pediatr. 1937;11:824-32.
3. Duncan AS. Standardizedsennaas a laxative in the puerperium. A clinical assessment. Br Med J. 1957;1:439-41. PMID:13396280

Substance Identification:

Substance Name:

Cascara Sagrada

CAS Registry Number:


Drug Class:

  • Cathartics

  • Gastrointestinal Agents

  • Administrative Information:

    LactMed Record Number:


    Last Revision Date:

    Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.