Is Rhubarb Safe in Breastfeeding

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

Dried roots of shrub are used. It contains heterosides hydroxyanthracenes, especially antraquinones (aloe-emodin and rhein) and dianthrones (senosides). Pharmacokinetic properties are those of emodin. Used for constipation. Commission E of German Health Ministry recommends to use no longer than one week, and 20 to 30 mg /day of rhein. Long-term use may be harmful to the GI tract. Elective treatment of constipation is an appropriate fiber-rich diet and a healthy style of life.

Rhubarb (Rheum officinale, Rheum palmatum) root contains anthraquinones (e.g., aloe-emodin, chrysophanol, emodin, rhein), which are laxatives, and tannins, which are astringents. Rhubarb has no specific lactation-related uses. It has been used for a wide variety of conditions, such as constipation, chronic renal failure, and upper gastrointestinal bleeding. It has also been used topically for conditions, such as herpes infections, and gingivitis. Most of these conditions are not supported by well-controlled trials. Other species of rhubarb are used primarily as foods. Chinese and garden rhubarb are "generally recognized as safe" (GRAS) as a food by the U.S. Food and Drug Administration. Two very old studies found that laxative doses of rhubarb given to nursing mothers did not appear to pass into milk or affect their breastfed infants.[1] Nevertheless, most recent reviewers state that rhubarb should not be used during breastfeeding because of possible cathartic effects on the breastfed infants.[2][3] Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information #about dietary supplements# is available elsewhere on the LactMed Web site.

In an old uncontrolled study, 9 nursing mothers were given 9.2 mL of rhubarb syrup on day 5 postpartum and each successive evening until discharge. Although all of the mothers had a laxative effect from this regimen, none of their breastfed infant had any noticeable laxative effects.[1]