Any advice for a lactulose novice?

[coppertop]

After talking to the Paed about ds1 (6yrs and ASD) the Paed has suggested that we try lactulose. I've looked through some of the old threads but wondered if anyone had any general advice or tips about it?

On one thread someone mentioned that it should be prescribed by a GP if it's for a child. Would this still apply to ds1 if the Paed has already okayed it?

Also, the Paed said it would be better for ds1 to 'go' in the mornings before school. How far in advance would I need to give him the lactulose for this, or do you all find it easier to aim for the evenings?

Sorry for all the questions but it's all very confusing. The appointment was actually for ds2 so there wasn't much time to ask the Paed for more detailed info.

It's not particularly fast acting CT. Giving it at night probably wouldn't give you a result by the next morning, you'll probably have to give it for a few days.

I'm not sure that you can buy lactulase over the counter so you may have to get a prescription. Your GP would maybe give it to you over the phone if you say that the paed has suggested it.

Is he proper bunged up or just not very regular? And what dose have they suggested? Dd was on lactulose for along time combined with senna and sometimes picolax Movicol is the only thing that 'sorted' her. TC had a thread on that recently.

The problem is that he's been pooing in his pants a lot and it's usually very runny. The Paed said that it was probably linked to his brain not getting the proper signals to say that he needs to go.

He suggested lactulose to start off with. He didn't mention a specific dose but said that ds1 would probably need a lot because of his size (he's very thin but is tall for his age). He said that if that didn't work that we should try Movicol or senna-something. He wrote it down for me so I've got it on a piece of paper.

Lovely subject for mid-morning lol!

Could be he's a bit blocked and the runny stuff is what is seeping around the outside of the blockage,especially if he does 'hold', either on purpose or because he doesn't get the urge. Lactulose is a stool softener and it sometimes works on it's own, sometimes it needs following with something to clear them out like picolax.

Hope you get a 'result' CT.

LOL! The poor boy would probably be mortified if he knew his bowel habits were being posted on the internet (or details about them anyway!)

ds2 has lactulose- i buy it from superdrug pharmacy counter.

it is basically undetectable if put in a drink of ribena/orange etc....

affects ds after 1 hour...causes gaseous expulsions.....!!!!.... the pooh is usually an hour or so later!!!

i ignored the dosage of 10/15ml...and gave only 5ml...intending to increase if needed...

i would get some, and what i have found works well for ds2 is to give it to him late as poss on friday night...hoping he'll be asleeep before it takes action...as then ds wakes as usual the next morning... and has a couple of 'clearouts'- better at home for that!!!!

DS1 is 5 and has lactulose once a day (5ml now, he used to be on 10ml a day). I had it prescribed to him by the GP, but you can buy it over the counter. I don't find ot to be particularly fast acting.
I have been trying to wean him off it, but if I miss doses he complains of stomach ache and the problems with going to the loo start again.
Remember that it is based on sugar, so always clean teeth thoroughly afterwards. I know one little boy who has decayed teeth and the dentist blames it on the lactulose, luckily it is his milk teeth and he is 4 so will be losing them soonish.

i have used lactulose on lily my 18mnth old and we both hated it! she hated the taste and it gave her stomach cramps and i hated getting it all over us whilst trying to get it down her throat! her bowel habits have now improved due to a change in diet and a gastrostomy but a pal of mine with a special needs baby uses movacol and says its great

I have used daily lactulose with dd2 who has SN since she was approx 2 (now 5) - prescribed by Paed (the Paed's prescriptions were always just accepted by our GP without question but you will need to get the GP to add it to your ds's regular prescriptions at your surgery.)

In dd's experience it is not fast acting, unlike a suppository, but you need to have a regular dose for a few days for it to get going (so to speak!) Then I think the idea is to keep it going to re-establish a normal bowel habit, and then gradually reduce it and see if things carry on as normal.

Perhaps your ds doesn't like 'going' at school? There is a very good organisation called 'Eric', which gives advice on 'continence issues'
here . It is a bit of a nightmare, I have been there with dd1 and dd2!

Thanks everyone. The Paed mentioned using it for about 6mths or so until ds1 gets used to the idea of going properly and then hopefully stopping it again.

It's interesting to see the range of effects and side-effects of it. I think I'll give it a go (or ds1 will!) and see what happens. I think aiming for a weekend start is probably a good idea, MissesF. I have a feeling that ds1 may well be inclined towards explosions.

He doesn't seem too bothered about going at school. Many's the time he's dashed off to the toilets as soon as the bell has gone and I've ended up waiting for 15 minutes for him. (Sorry, ds1 )

Thanks everyone. The Paed mentioned using it for about 6mths or so until ds1 gets used to the idea of going properly and then hopefully stopping it again.

It's interesting to see the range of effects and side-effects of it. I think I'll give it a go (or ds1 will!) and see what happens. I think aiming for a weekend start is probably a good idea, MissesF. I have a feeling that ds1 may well be inclined towards explosions.

He doesn't seem too bothered about going at school. Many's the time he's dashed off to the toilets as soon as the bell has gone and I've ended up waiting for 15 minutes for him. (Sorry, ds1 )

strangely I was once told by dd's nurse that the runny motions can be a sign of constipation
Lactulose softens the motions and makes them easier to pass. dd is 11 and is on 10ml twice a day (also senna) and it works.
top tip allow him time. say let him read or listen to music or something so he soesn't "rush" that was advice given to my db when he was little and had trouble.

oh and get it on repeat prescription as it is at least £2.50 for a 300ml bottle.

I was told that you need to keep his fluids up too. I think lactulose works as it is a sugar solution and it absorbs water from the body into the gut and softens the stool making it easier to pass. (That's probably completely wrong)DS4 has hypotonia nad gets constipated frequently.