Can I have some Lactulose advice please?

[SleepFreeZone]

We have had problems with my toddler re. pooing in the toilet - i.e. he won't! This has led to him withholding his poo and only going every third day or so. When he does go in his nappy it's absolutely ginormous and quite hard.

So I talked to the pharmacist and we are trying 5ml of Lactulose twice a day. He started on Saturday. He doesn't like the taste of it at all. I am getting it down him but I can foresee we might get to a point where it's a battle. Is it possible to put it in a food at all, yogurt maybe? Also is 5ml twice a day a good dose for a 4 year old? The effects at the moment seem to be very mild. He still seems to be able to withhold the poo at will but did go on Sunday after some persuasion, in his nappy of course, and it seemed softer.

Any advice really welcome as ideally I'd love him to be going once a day and then maybe we stand more chance of getting him to use the toilet.

Try senna at the same time - all lactulose does is soften the poo, whereas senna stimulates the muscles and gives the brain a signal of needing to go. Years of pointless movicol and lactulose led us to this solution with our toddler. Give senna 12 hours before you want the poo to turn up - it will be like clockwork. If 2.5ml doesn't work, increase by 1ml a day until you're getting something daily then reduce back down by 1ml / day, holding at any point when you're not getting something daily. Have patience it could take months. And look at the ERIC charity website. (Our poo dr who advised the above is one of the advisors / patrons)

Oooooh fascinating! Thank you so much for answering 💐

What senna product do you use?

We use movical every other day here ( prescription ) and lactulose when that isn't enough, Baby is tube fed but I've used it in the past with my 4yr old DD and mixed it in with the milk she had in the morning and in some yogurt.
Movical doesn't taste of much at all, you could mix it in with a small cup of water (60-80mls) or so.

sorry *movicol.

it was just generic brand in giant bottles. Dr Poo advised us not to tell the pharmacist it was for a child!

The issue we had with the lactulose and movicol is that they liquify everything and you end up with poo running uncontrollably down legs (eg when you're in the Science Museum...) and a very sore, distended gassy tummy. The senna doesn't soften (so you may need some lactulose and definitely lots of water / dietary fibre), but causes the muscles of the stomach to spasm so they know they need to go - there's an indication beforehand that something is going to happen whereas with the movicol (backed by very expensive drug co marketing campaigns, hence great popularity according to Dr Poo, who is cynical) doesn't address any control issues. Emergency use for clear out only. Good luck!