Lactulose

(Date of issue: November 2013. Version: 1.1)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

Constipation during pregnancy

Constipation is very common during pregnancy and is thought to be due to the effects of the normal hormonal changes of pregnancy on the bowel. Although uncomfortable, it is generally not harmful to the mother or baby.

How do I avoid or treat constipation in pregnancy?

Pregnant women should ensure that their diet is high in fibre and that they drink plenty of liquid from early pregnancy onwards. Fibre is found in fresh fruits and vegetables, wholemeal bread and wholegrain breakfast cereals. Prunes or prune juice and regular exercise can also help prevent and treat constipation. By following this advice you can hopefully avoid needing to take medicines to treat constipation.

If your constipation has not improved after trying these suggestions your doctor may advise you to take a medicine (laxative).

Is it safe to take laxatives in pregnancy?

As is the case for many medicines, there are too few scientific studies to prove that medicines for constipation (laxatives) are safe. However, several medicines have been used in pregnancy for many years without any known effects on the developing baby. 

This leaflet summarises the scientific studies relating to the effects on a baby in the womb of medicines that are commonly used to treat constipation. It is advisable to consider this information if you are pregnant. For some women, treatment with a laxative in pregnancy may be necessary.

It is important to avoid using laxatives for long periods of time during pregnancy as this can lead to dehydration and unbalanced levels of salts and minerals in your body. Make sure you speak to your doctor or health care provider before taking any medicine in pregnancy.

What information is there about the use in pregnancy of specific laxatives?

Bulk-forming laxatives
Bulk-forming laxatives (e.g. wheat bran, linseed, ispaghula (Fybogel,® Isogel,® Ispagel,® Regulan®), methylcellulose (Celevac®), and sterculia (Normacol®)) are not absorbed into the bloodstream but increase the bulk of the stools (faeces) which helps movement along the bowel. Use of bulk-forming laxatives during pregnancy is common and has not been linked to any problems in the unborn baby.

Lactulose
Lactulose (Duphalac,® Lactugal,® Laevolac®) is a type of sugar that is not digested and therefore draws water into the bowel. This softens the stools and helps them to move along the bowel. No studies have been carried out to examine whether using lactulose during pregnancy is linked to problems in the unborn baby. However, lactulose is commonly used during pregnancy and the manufacturers of Duphalac® state that it may be used during pregnancy if necessary.

Glycerin suppositories
Glycerin suppositories lubricate and stimulate the bowel. They are generally used for more severe constipation. No studies have been carried out to examine whether using glycerine suppositories during pregnancy is linked to problems in the unborn baby, but these are quite commonly used during pregnancy and no problems have been reported.

Bisacodyl
Bisacodyl (Dulcolax®) stimulates the bowel and increases the water content of the stools. No studies have been carried out to examine whether using bisacodyl during pregnancy is linked to problems in the unborn baby, however no problems have been reported.
 
Senna
Senna (Senokot®) stimulates the bowel muscles, helping to move stools along. One study has investigated the use of senna during pregnancy and showed that women who used senna during the first twelve weeks of pregnancy (the main period of pregnancy during which a baby is formed) were no more likely to have a baby with a birth defect than women who didn’t.

Docusate sodium
Docusate sodium (Dioctyl,® Docusol®) stimulates the bowel muscles, helping the stools to move along more easily. Three studies have all shown no increased risk of having a baby with a birth defect in women who used docusate sodium during the first 12 weeks of pregnancy, which is when most of a baby’s body develops.

Sodium picosulfate
Sodium picosulfate (Dulcolax Pico®) stimulates the bowel muscles to help stools to move along more easily. No studies have been carried out to examine whether using sodium picosulfate during pregnancy is linked to problems in the unborn baby. However, no problems have been reported after use during pregnancy.

Macrogols
Macrogols (Laxido,® Molaxole,® Movicol®) increase the water content of the stools, helping them to pass through the bowel. No studies have been carried out to examine whether using macrogols during pregnancy is linked to problems in the unborn baby, however no problems have been reported.

Will my baby need extra monitoring during pregnancy?

There is no evidence that taking laxatives during pregnancy causes any problems that would require extra monitoring for your baby.

Are there any risks to my baby if the father has taken laxatives?

We would not expect any increased risk to your baby if the father took laxatives before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.  

General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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