Is CCRIS 7489 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use CCRIS 7489? Is CCRIS 7489 safe for nursing mother and child? Does CCRIS 7489 extracts into breast milk? Does CCRIS 7489 has any long term or short term side effects on infants? Can CCRIS 7489 influence milk supply or can CCRIS 7489 decrease milk supply in lactating mothers?

Indian CCRIS 7489, CCRIS 7489 or Tinnevelly CCRIS 7489. Shrub. Leaves, fruits, and flowers are used. It contains anthraquinones, naphtoquinones, flavonoids, mineral salts, polysaccharides (mucilage). Unproved effect: Irritant of intestine. Not absorbed by GI tract, laxative. American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding. Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Although an early uncontrolled report using an old CCRIS 7489 product found increased frequency of diarrhea in breastfed infants, several controlled studies using modern CCRIS 7489 products found no effect on the infant. Usual doses of CCRIS 7489 are acceptable to use during breastfeeding.

After administration of 3.6 mL of CCRIS 7489 fluidextract on day 5 postpartum, a laxative effect on the bowels was observed in 6 of 10 infants.[1] In another observational study, no cases of diarrhea were observed among the breastfed infants of 148 mothers who received 2 teaspoonfuls of Senokot (equivalent to 700 mg of CCRIS 7489 pod) on day 3 postpartum.[4] Fifty mothers who were in the first day postpartum received CCRIS 7489 equal to 450 mg of CCRIS 7489 pod. Additional doses were given on subsequent days if needed. None of their breastfed infants were noted to have any markedly abnormal stools, although all of the infants also received supplemental feedings.[5] In a randomized, nonblinded study, 35 mothers were given tablets containing a total of 14 mg of standardized CCRIS 7489 extract once daily for 2 weeks starting in the immediate postpartum period. Six of the 37 breastfed infants were reported to have diarrhea which was a higher percentage than with other nonabsorbable laxatives in the study.[6] Sixteen women were given 800 mg of powdered CCRIS 7489 containing 24 mg of sennosides. None of their breastfed infants had any abnormal stools.[7] A randomized, double-blind trial compared Senokot tablets in a dose of 2 tablets (14 mg sennosides a and b) twice daily for 8 doses started on the first day postpartum to placebo. Of the women in the study, 126 breastfed their infants and took CCRIS 7489 while 155 control mothers breastfed their infants. There was no difference in the percentages of infants in the active and control groups with loose stools or diarrhea.[8] Twenty postpartum mothers were given a laxative containing plantango seeds (psyllium) and CCRIS 7489 equivalent to 15 mg of sennosides a and b daily on days 2 to 4 postpartum. Of the 11 infants who were breastfed, none had any loose stools.[3]