GP and pharmacist giving conflicting advice

[Element4056]

Since giving birth nearly 3 weeks ago I have been constipated. When I first spoke to mu GP she prescribed me senna as a laxative. I queried whether this is safe for breastfeeding as my baby was less than 2 weeks old. She said it's fine to take whilst breastfeeding.
I sent my husband to the pharmacy and he double checked with the pharmacist who stated this is unsafe for breastfeeding a baby less than a month old.
Instead the pharmacist recommended fybogel. As I was still constipated I also bought lactulose which helped with bowel movements the first time.
I have now been constipated again for nearly 10 days and taking lactulose and fybogel hasn't helped like the first time. I called my GP today and she prescribed movicol. Again i reiterated that my baby is less than 3 weeks and breastfeeding. She said it was fine to take.
I sent my husband to the pharmacy and the pharmacist recognised him from before. The pharmacist called over another pharmacist colleague of his and they both stated that movicol cannot be taken whilst breastfeeding a newborn at less than 3 weeks old. I am so baffled. Why would my GP prescribe these laxatives if they are unsafe to take whilst breastfeeding?
The pharmacist recommended I take laxido instead which my husband purchased.
I'm annoyed as I am entitled to free prescriptions and instead have had to buy lactulose, fybogel and now laxido due to my GP prescribing medication I cannot take.
Can someone in the medical field with knowledge please advise if movicol is indeed unsafe to take whilst breastfeeding my less than 3 week old? I'm frustrated that I am getting conflicting advice from both the GP and pharmacist.
Thank you for reading.

Hi OP use this website
www.breastfeedingnetwork.org.uk/drugs-factsheets/

It's run by a leading pharmacist who researches and publishes all the fact sheets for drugs possible to breastfeed with and any precautions required

Constipation section states

"Osmotic laxatives work by increasing the amount of fluid in the large bowel. These also have a delay in action but it is generally shorter than bulk laxatives. They help to produce softer bowel movements, which are easier to pass. E.g. Magnesium Hydroxide, Magnesium Sulphate, Lactulose, Movicol ®. Passage of osmotic laxatives into breastmilk is low and they can all be used during breastfeeding."

www.nhs.uk/medicines/macrogol/

This says movicol is ok and that Laxido is the same thing as movicol but a different brand name

From the nhs link

Macrogol is also called by the brand names Movicol, Laxido, CosmoCol, Molaxole or Molative

Scottishskifun beat me to it. It’s a great resource, and might be useful to feed this back to the pharmacist who has given you incorrect advice.

Pharmacists are very risk averse - there are loads of OTC medications for example that they won't let you have in pregnancy but which you can get via your GP. It's generally because it's not ethical to test medication on pregnant/BFing women.

Senna does say not under 1 month old under the breastfeeding section of the BNF.
Your GP could have checked this, but obviously didn't. Pharmacist is more likely to know without looking it up.

Movicol and Laxido are the exact same product, DS has it on repeat prescription and gets one or the other depending on which GP writes up the script. I had both after having DC and BFing and it was fine.

Movicol and laxido are the same thing just different brand names for macrogol. Senna is definitely safe when BF as I was given it when discharged from hospital breastfeeding my newborn. If the pharmacist is querying a prescription they should go back to the prescriber really not the patient. The breastfeeding network and BNF both say macrogol based laxatives are safe in BF mothers.

@31thebakeoffwasntasgoodthisyear yes it's a brilliant help I've even fed it back to GPs who weren't sure when I needed a prescription!

I had both lactulose and molvocol while breastfeeding straight after having my son. Both were prescribed by the hospital after a 4th degree tear. Baby was completely fine. I ended up taking them for a fair chunk of time as well!

My dsis is a pharmacist, they don't like giving any medication to pregnant/breastfeeding women, most medication will say on it to seek advice from gp before taking if pregnant/breastfeeding, so if a dr has prescribed it, it is usually fine (but do your own research on website op posted) It is just that there is slightly less research done on the effects on pregnant/breastfeeding women.

I had one pharmacist refuse me worming tablets while I was pregnant even though my gp had prescribed them for my dd, I then called my dsis, & went to see one of her colleagues who did serve me them as she looked up the info on the website a pp linked above.

Laxido is movicol, just a different brand. Lactulose takes several diesels to work.

Doses.

Midwife here, we have all of those as ward stock on the postnatal ward! I can confirm they are routinely prescribed to breastfeeding mums of newborns.

As others have stated movicol and laxido are just different brands containing the same active ingredients. Very odd the pharmacist would give one and not the other.

they don't like giving any medication to pregnant/breastfeeding women

I was told the same. Was prescribed some stronger pain relief during 3rd Tri for joint pain in my hips and was told to send DH to pick it up as they'd likely refuse to give it to me if they saw I was pregnant.

Told by the GP prescribing that was ^^

You need a tin of prunes. You'll be going in no time, promise.
From a fellow constipated breastfeeder, albeit 4 years on for me now.

Laxido and Movicol are exactly the same thing, I think the pharmacist was ripping you off.

Senna is fine to use too.

All the leaflets will have caution notes for pregnant/BF women but GPs will prescribe based on your symptoms and what is clinically indicated. Hence why the mild stuff did not work but stronger stuff prescribed by GP will. Plus, you can return to GP if you get any listed side effects.

@ExpulsoCorona

Laxido and Movicol are exactly the same thing, I think the pharmacist was ripping you off.

Senna is fine to use too.

This^

Laxido is exactly the same as Movicol. They are both brand names of Macrogol which is safe to use whilst breastfeeding.

How can a pharmacist not know this? That Laxido is the same as Movicol?

OP, if I were you I would seriously consider never returning back to that pharmacy, let alone ever seeking advise from them.

My experience is that pharmacists are wary of selling over the counter medicines to pregnant women or breastfeeding women. GPs are often better placed to make a medical call on
pregnancy/breastfeeding and pharmacists will be happier issuing a prescription because someone else has taken medical responsibility

If I know something is ok then I tend to send DH to buy it or don't mention that I'm breastfeeding.

I did my MSc dissertation on excretion of drugs in breast milk years ago.
The real issue is that often the product packaged to be sold in a pharmacy will have a different licence conditions to the prescription version. Most will exclude sale to pregnant and nursing mothers - it seems to be the MHRA standard. It's not that pharmacists are more cautious it's that they have to adhere to the licence. (Or the summary of product characteristics to give its proper name).
However I would complain to the pharmacist about the Laxido sale when you had a movicol script. That was appalling. I would definately demand a refund and if it is a chain, complain to their head office.
The Senna is different slightly but pharmacist should have spoken to the prescriber.
Lactulose is not a treatment for acute constipation but is intended to keep stools soft and for longer term use.

Do you drink plenty water OP? I would also try really upping your water intake as well as prunes etc other things good for bowel movements.