Castor and Breastfeeding

Summary of use during lactation

Castor (Ricinus communis) beans contain triglycerides, mostly consisting of ricinoleic acid esters, and small amounts of the toxic ricin and ricine. Pressing of the beans produces castor oil and purification of the oil eliminates the ricin and ricine. Castor oil is a strong stimulant laxative. Castor beans as well as a homeopathic preparation of castor purportedly reduce milk flow,[1] but it is also reportedly used as a galactogogue.[2-4] A poultice of castor leaves is also a purported galactogogue.[5,6] In some parts of India, castor oil is also reportedly applied to the breasts to stimulate lactation.[6] No scientifically valid clinical trials support any of these uses and some preparations may be toxic to the infant. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production.[7,8] No data exist on the excretion of any components of the castor plant or castor oil into breastmilk or on their safety and efficacy in nursing mothers or infants. However, little of the active ricinoleic acid is thought to be absorbed from the intestine. Because of a lack of information, other cathartics may be preferred in nursing mothers. In traditional Indian culture, castor oil has been administered to newborn infants during the first 2 to 3 days of life, often resulting in adverse effects.[9,10] Administration of castor oil to newborns is dangerous and should be avoided. 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 prove 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 not 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.

Drug levels in milk and infant serum

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

Effects in breastfed infants

In rural India, castor oil has been traditionally given to infants during the first 2 to 3 days of life to clear the intestine of meconium. This practice can result in paralytic ileus and aspiration pneumonia.[9] Severe hypoalbuminemia was also reported in a 1.5-month-old infant whose grandmother gave him castor oil daily from the fifth day of life, resulting in diarrhea and malnutrition.[10]

Effects on lactation and breastmilk

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

Alternative drugs to consider

(Cathartic) Bisacodyl, Magnesium Hydroxide, Senna

References

1. Hardy M. Women's health series: Herbs of special interest to women. J Am Pharm Assoc (Wash) 2000;40:234-42.10730024 PubMed
2. Eglash A. Treatment of maternal hypergalactia. Breastfeed Med 2014;9:423-5.25361472 PubMed
3. Winterfeld U, Meyer Y, Panchaud A, et al. Management of deficient lactation in Switzerland and Canada: A survey of midwives' current practices. Breastfeed Med 2012;7:317-8.22224508 PubMed
4. Dandotiya H, Singh G, Kashaw S. The galactagogues use by Indian tribal communities to over come poor lactation. Int J Biotechnol Bioeng Res 2013;4:243-8. http://www.ripublication.com/Volume/ijbbrv4n3spl.htm
5. Yarnell E. Botanical medicine in pregnancy and lactation. Altern Complement Ther 1997;3 (April):93-100. doi:10.1089/act.1997.3.93
6. Rasiya B, A, Nayar T. Plants used for natal healthcare in folk medicine of Kerala, India. Indian J Tradit Knowl 2011;10:523-7.
7. Brodribb W. ABM Clinical Protocol #9: Use of galactogogues in initiating or augmenting maternal milk production, second revision 2018. Breastfeed Med 2018;13:307-14.29902083 PubMed
8. Breastfeeding challenges: ACOG Committee Opinion, Number 820. Obstet Gynecol 2021;137:e42-e53.33481531 PubMed
9. Benakappa D, Raju M, Shivananda, et al. Breast-feeding practices in rural Karnataka (India) with special reference to lactation failure. Acta Paediatr Jpn 1989;31:391-8.2514560 PubMed
10. Jayaprakash D, Raghu R, TS, Singh D, et al. Laxative induced hypoalbuminemia. Indian Pediatr 1995;32:1037-8.8935275 PubMed