Soft Laxatives for Infants: Addressing Your Concerns

Lactulose laxative

Hello doctor, I would like to ask why my three-month-old baby experiences continuous abdominal pain after taking the softener prescribed by the doctor.
Is this normal? Last Monday, the doctor mentioned that my baby had hard stools, but prior to that, my baby was having daily bowel movements.
Later, the doctor prescribed a softener called Lacto for my baby to take 3cc in the morning and evening for a week.
This past Monday, during the follow-up visit, the doctor did not perform a physical examination and simply instructed to continue the Lacto softener for another two weeks, reducing the dosage to 2cc twice a day this week, and then to 2cc once a day next week.
However, after taking the medication this week, my baby has been experiencing persistent abdominal pain and discomfort.
The doctor also prescribed probiotics for my baby.
I would like to know if my baby should continue taking the medication if it causes pain.
Since my baby has been able to pass hard stools without discomfort or crying since last week, should I continue giving the medication?

Guo Xiaojie, 30~39 year old female. Ask Date: 2022/11/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

For pediatric issues, it is recommended to consult a pediatric gastroenterologist.
If there are no symptoms present, it is generally acceptable to discontinue medication and monitor the situation.

Reply Date: 2022/11/23

More Info

When it comes to the use of soft laxatives in infants, particularly in your three-month-old baby, it’s essential to understand both the purpose of these medications and the potential side effects they may cause. Soft laxatives, such as the one your doctor prescribed (likely a form of polyethylene glycol or similar), are often used to treat constipation in infants. They work by drawing water into the intestines, which helps to soften the stool and make it easier to pass.

However, it is not uncommon for infants to experience some discomfort or abdominal pain when starting a new medication, including laxatives. This discomfort can arise for several reasons:
1. Adjustment Period: Your baby's digestive system is still developing, and introducing a laxative can lead to temporary changes in bowel habits and gastrointestinal discomfort. This adjustment period can cause cramping or pain as the intestines adapt to the increased fluid and softer stool.

2. Dosage: The dosage of the laxative may need to be adjusted based on your baby's response. If the dose is too high, it can lead to excessive fluid in the intestines, causing cramping and discomfort. It's crucial to follow the doctor's instructions closely and communicate any concerns about the dosage.

3. Underlying Conditions: While it sounds like your baby was experiencing constipation, it’s essential to rule out any underlying gastrointestinal issues that could be contributing to the pain. If the constipation was severe, the intestines might have been stretched, leading to discomfort even after the stool has passed.

4. Combination with Other Medications: If your baby is taking multiple medications, such as the soft laxative and a medication like "益腹寧" (which may be a probiotic or another digestive aid), there could be interactions or cumulative effects that lead to discomfort.

Given that your baby has been able to pass hard stools since starting the laxative and is no longer crying during bowel movements, it suggests that the primary issue of constipation may be resolving. However, the ongoing abdominal pain is concerning. Here are some steps you can take:
- Monitor Symptoms: Keep a close eye on your baby's symptoms. If the abdominal pain persists or worsens, or if you notice any other concerning signs (such as vomiting, fever, or changes in appetite), it is essential to consult your pediatrician immediately.

- Consult Your Pediatrician: Given that your baby is experiencing discomfort after taking the laxative, it would be wise to contact your pediatrician. They can assess whether the current treatment plan is appropriate or if adjustments are needed. They may suggest reducing the dosage or trying a different approach to manage your baby's bowel health.

- Hydration and Diet: Ensure that your baby is well-hydrated, as adequate fluid intake can help prevent constipation. If your baby is breastfeeding, continue to do so, as breast milk is generally well-tolerated and can help with digestion. If formula-fed, ensure that the formula is appropriate for your baby's age and needs.

- Gentle Abdominal Massage: Sometimes, gentle abdominal massage can help relieve discomfort in infants. You can try gently massaging your baby's tummy in a clockwise motion to help ease any cramping.

In conclusion, while it is not uncommon for infants to experience some discomfort when starting a laxative, persistent abdominal pain should not be ignored. It’s crucial to maintain open communication with your healthcare provider to ensure your baby receives the best care possible.

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