The Basics
What is Willow Bark / Citrus aurantiu?
Widely used in weight loss and weight management products.
Brand names for Willow Bark / Citrus aurantiu
Na
How Willow Bark / Citrus aurantiu is classified
Complementary Therapies, Phytotherapy, Plants, Medicinal
Willow Bark / Citrus aurantiu During Pregnancy
Willow Bark / Citrus aurantiu pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Willow Bark / Citrus aurantiu while pregnant
N/A
Taking Willow Bark / Citrus aurantiu While Breastfeeding
What are recommendations for lactation if you're taking Willow Bark / Citrus aurantiu?
Willow (Salix sp.) bark contains salicylic acid and its derivative salicin. Willow bark has no specific lactation-related uses. It is traditionally used to treat fever and inflammatory conditions, but it also is found in some weight loss products. After salicylate or salicin ingestion, salicylic acid is excreted into breastmilk. The excretion of salicylate into breastmilk increases disproportionately as the maternal dosage increases. Long-term, high-dose maternal aspirin ingestion probably caused metabolic acidosis in one breastfed infant. Reye’s syndrome is associated with aspirin administration to infants with viral infections, but the risk of Reye’s syndrome from salicylate in breastmilk is unknown. Willow bark is best avoided during breastfeeding. Safer drugs are available for pain and fever. 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.
Maternal / infant drug levels
Willow (Salix sp.) bark contains salicylic acid and its derivative salicin. Willow bark has no specific lactation-related uses. It is traditionally used to treat fever and inflammatory conditions, but it also is found in some weight loss products. After salicylate or salicin ingestion, salicylic acid is excreted into breastmilk. The excretion of salicylate into breastmilk increases disproportionately as the maternal dosage increases. Long-term, high-dose maternal aspirin ingestion probably caused metabolic acidosis in one breastfed infant. Reye’s syndrome is associated with aspirin administration to infants with viral infections, but the risk of Reye’s syndrome from salicylate in breastmilk is unknown. Willow bark is best avoided during breastfeeding. Safer drugs are available for pain and fever. 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.
Possible effects of Willow Bark / Citrus aurantiu on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Willow Bark / Citrus aurantiu
(Fever, Pain) Acetaminophen, Ibuprofen.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Levy G. Salicylate pharmacokinetics in the human neonate. In, Morselli PL, Garattini S, Sereni F, eds. Basic and therapeutic aspects of perinatal pharmacology. 1975;Raven Press :New York:319-30.
2. Putter J, Satravaha P, Stockhausen H. Quantitative analysis of the main metabolites of acetylsalicylic acid. Comparative analysis in the blood and milk of lactating women. Z Geburtshilfe Perinatol. 1974;178:135-8. PMID: 4422623
3. Jamali F, Keshavarz E. Salicylate excretion in breast milk. Int J Pharm. 1981;8:285-90.
4. Findlay JW, DeAngelis RL, Kearney MF et al. Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther. 1981;29:625-33. PMID: 7214793
5. Bailey DN, Welbert RT, Naylor A. A study of salicylate and caffeine excretion in the breast milk of two nursing mothers. J Anal Toxicol. 1982;6:64-8. PMID: 7098450
6. Unsworth J, d’Assis-Fonseca A, Beswick DT. Serum salicylate levels in a breast fed infant. Ann Rheum Dis. 1987;46:638-9. PMID: 3662653
7. Clark JH, Wilson WG. A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate. Clin Pediatr (Phila). 1981;20:53-4. PMID: 7449246
8. Terragna A, Spirito L. [Thrombocytopenic purpura in an infant after administration of acetylsalicylic acid to the wet-nurse]. Minerva Pediatr. 1967;19:613-6.
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
