Any laxative can be used during breastfeeding although prucalopride should be used with caution. Recommendations apply to full term and healthy infants.

General considerations

It is important to complete an individual risk assessment for your patient and to apply the principles of prescribing in breastfeeding when looking at the available information and making treatment decisions.


Any laxative can be used during breastfeeding as most are either not absorbed or minimally absorbed from the gastrointestinal tract leading to low or negligible levels in breast milk.

Prucalopride can be used with caution whilst breastfeeding as it is excreted into breast milk in small levels.  Other laxatives are preferable but, given its place in therapy, may already have been tried.

Lifestyle interventions such as increased dietary fibre and exercise should always be tried first. Maintaining fluid intake will also help with milk supply. If a laxative is needed, always use the lowest dose for the shortest time possible.

Clinical considerations

There are three main types of laxatives—bulk-forming, osmotic or stimulant. In addition, prucalopride is a selective serotonin 5HT4-receptor agonist which is used for chronic constipation where other laxatives have failed.

Treatment choice should be primarily based on clinical indications, with suitability in breastfeeding as a secondary consideration.

In some cases, constipation may be a sign of dehydration.  Drinking fluids is important to maintain sufficient breast milk supply in addition to helping relieve constipation.

Specific recommendations

The following specific laxative recommendations have been grouped by mechanism of action.

Bulk-forming laxatives

Osmotic laxatives

Stimulant laxatives

Selective serotonin 5HT4-receptor agonists

Patient Information

The NHS website provides advice for patients on the use of specific medicines in breastfeeding.

Contact us

Get in touch with the UK Drugs In Lactation Advisory Service (UKDILAS), our specialist breastfeeding medicines advice service if you need support in the following situations:

  • you need further advice
  • the medicine in question is not included here
  • the infant is unwell or premature
  • multiple medicines are being taken

About our recommendations

Recommendations are based on published evidence where available. However, evidence is generally very poor and limited, and can require professional interpretation. Assessments are often based on reviewing case reports which can be conflicting and lack detail.

If there is no published clinical evidence, assessments are based on: pharmacodynamic and pharmacokinetic principles, extrapolation from similar drugs, risk assessment of normal clinical use, expert advice, and unpublished data. Simulated data are now increasingly being used due to the ethical difficulties around gathering good quality evidence in this area.


Full referencing is available on request.

Update history

  1. Editorial change only.
  1. Published

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