Is Sodium Phosphate safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Sodium Phosphate. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Phosphate is a normal constituent of breastmilk. Phosphate concentrations have not been measured in breastmilk after large maternal doses of sodium phosphate, such a 30 gram oral dose for pre-procedural bowel evacuation. However, the added phosphate in breastmilk is likely to be only about 130 mg over 24 hours in this situation. The increase from a typical dose of a rectal enema would be considerably less than this amount. Breastmilk sodium concentration is tightly regulated, and will not be affected. It is probably not necessary to suspend breastfeeding after the use of oral sodium phosphate solutions given once or twice for bowel evacuation before a procedure. Use of a phosphate rectal enema by a nursing mother would require no special precautions.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Phosphate is a normal constituent of breastmilk.[1,2] Infants normally receive about 130 mg of inorganic phosphate daily from breastmilk.[2]
Maternal Levels. Administration of a 30 gram dose of oral sodium phosphate solution (e.g., Visicol) approximately doubles the maternal serum phosphate concentration, with serum concentrations returning to baseline about 24 hours after the dose.[3,4] Assuming breastmilk phosphate concentration also doubles, the increased phosphate dose to the infant would be only 130 mg for one day.
Administration of a phosphate enema (2 Fleet Enemas, containing a total of 14 grams of sodium phosphate dibasic and 38 grams of sodium phosphate monobasic) to 33 subjects increased serum phosphate by an average of about 25% (range 0.1 to 2.5 mg/dL).[5] In one other patient, a phosphate enema (Practo Clyss 120, containing a total of 7.2 grams of sodium phosphate dibasic and 19.2 grams of sodium phosphate monobasic) increased serum phosphate by 35% (by 0.8 mmol/L) after a single dose.[6]
Infant Levels. Relevant published information was not found as of the revision date.
“No published information” means the studies do not exist yet — not that Sodium Phosphate is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Sodium Phosphate” (LM988). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.