Chenodiol and Breastfeeding

Summary of use during lactation

Chenodiol (chenodeoxycholic acid) and its conjugates are naturally present in human milk, with higher milk levels of chenodiol conjugates in obesity. Chenodiol has not been measured in milk after administration as a drug. Chenodiol in the infant’s gastrointestinal tract enhances intestinal motility. No special precautions are required if mothers are taking chenodiol, but observe the infant for diarrhea.

Drug levels in milk and infant serum

Maternal Levels. In a small study of women who were 2 to 3 days postpartum who were not taking any exogenous bile acids, obese women had bile acid levels in milk that were about equal to those in plasma, unlike women of normal weight who had milk levels of about 10% of plasma levels. Chenodiol conjugate levels were higher in the milk of obese mothers than normal-weight mothers.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Chenodiol acts directly on enterochromaffin cells in the gastrointestinal tract to stimulate 5-hydroxytryptamine secretion, which regulates gastrointestinal motility. Chenodiol stool levels were higher in breastfed infants with increased defecation frequency than in infants with normal or lower frequency.[2]

Effects on lactation and breastmilk

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

Alternative drugs to consider

Ursodiol

References

1. Marousez L, Descat A, Kouach M, et al. Maternal obesity increases breast milk bile acid levels. J Clin Endocrinol Metab 202541061665 PubMed
2. Shan Z, He C, Yang Q, et al. Chenodeoxycholic acid activates the TGR5/TRPA1-5-HT pathway to regulate intestinal motility in breastfed infants and mouse models. Transl Pediatr 2025;14:1213–29.40688229 PubMed