This sheet is about exposure to fluoxetine in pregnancy and while breastfeeding. This information is based on available research studies. It should not take the place of medical care and advice from your healthcare provider.

What is fluoxetine?

Fluoxetine is a medication that has been used to treat depression, obsessive-compulsive disorder (OCD), Tourette’s syndrome, bulimia nervosa, panic disorder, and premenstrual dysphoric disorder (PMDD). Fluoxetine has also been used to treat body dysmorphic disorder, hot sweats, posttraumatic stress disorder (PTSD), and Raynaud’s phenomenon. Some brand names for fluoxetine are Prozac®, Prozac Weekly®, Rapuflux®, Selfemra®, and Sarafem®. Fluoxetine belongs to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Stopping this medication suddenly can cause some people to have withdrawal symptoms. It is not known if or how withdrawal might affect pregnancy.

If you plan to stop this medication, your healthcare provider might suggest that you slowly lower the dose instead of stopping all at once. Some people might have a return of their symptoms (relapse) if they stop this medication during pregnancy. If you stop taking this medication, it is important to have other forms of support in place (e.g. counseling or therapy) and a plan to restart the medication after delivery, if needed. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

For more information about depression or anxiety, please see our fact sheets at https://mothertobaby.org/fact-sheets/depression-pregnancy/ or at https://mothertobaby.org/fact-sheets/anxiety-fact/.

I take fluoxetine. Can it make it harder for me to get pregnant?

Fluoxetine has been studied in women having medical treatments because they were already having a hard time getting pregnant. In these studies, those who took fluoxetine got pregnant at the same rate as those who did not take fluoxetine.

Does taking fluoxetine increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. A small number of studies did not find a greater chance of miscarriage when fluoxetine was used in pregnancy.

Does taking fluoxetine increase the chance of birth defects?

Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like fluoxetine, might increase the chance of birth defects in a pregnancy. Fluoxetine use is not expected to increase the chance of birth defects. There are reports of over 10,000 pregnancies exposed to fluoxetine in the first trimester (when many major birth defects can happen). No pattern of birth defects has been found and most studies have not found an increased chance of birth defects related to fluoxetine use.

Some studies have suggested an increased chance of heart defects or other birth defects. However, there is no proven increased chance of birth defects directly related to fluoxetine.

Does taking fluoxetine in pregnancy increase the chance of other pregnancy-related problems?

Some studies suggest a higher chance of preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) with the use of fluoxetine in pregnancy. However, research has also shown that when conditions such as depression or anxiety are untreated or undertreated during pregnancy, there could be an increased chance of pregnancy complications. This makes it hard to know if it is the medication, the underlying condition, or other factors that might increase the chance for these problems.

Some, but not all, studies have suggested that when women who are pregnant take SSRIs during the second half of pregnancy, their babies might have an increased chance for a serious lung condition called persistent pulmonary hypertension (PPH). PPH happens in 1 or 2 out of 1,000 births. A recent report that combined results from several studies suggested the chance for PPH might be increased if an SSRI was used during pregnancy. However, it was not clear if this was due to medication exposure or to other exposures that people who take SSRIs have in common, such as higher rates of smoking. Data from studies suggest the overall chance for PPH when an SSRI is used in pregnancy is less than 1/100 (less than 1%).

I need to take fluoxetine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of fluoxetine during pregnancy and/or in the third trimester can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms include being irritable and/or jittery, crying, tight muscles, trouble breathing, unusual sleep patterns, tremors (shivers), and/or trouble eating. In most cases symptoms are mild and go away in a few weeks with no treatment, or with only supportive care. Not all babies exposed to fluoxetine will have these symptoms. There might be a higher chance for withdrawal symptoms if other psychiatric medications are also taken with fluoxetine during pregnancy. It is important that your healthcare providers know you are taking fluoxetine so that if symptoms occur your baby can get the care that is best for them.

Does taking fluoxetine in pregnancy affect future behavior or learning for the child?

A few studies have looked at the development of children from age 16 months to 7 years and did not find differences between children who were exposed to fluoxetine during pregnancy and those who were not. Most studies found no increase in attention deficit hyperactivity disorder (ADHD) in children exposed to SSRIs like fluoxetine during pregnancy. Most studies also find that SSRIs like fluoxetine do not appear to increase the chance of autism spectrum disorders (ASD) after adjusting for factors such as maternal illness.

Breastfeeding while taking fluoxetine:

Fluoxetine gets into breastmilk and most reports find no side effects in breastfed babies. In a small number of cases, irritability, vomiting, diarrhea, and less sleep have been reported. One study noted slightly less weight gain in infants exposed to fluoxetine via breast milk; however, this would likely only be an issue if the infant’s weight gain was already a concern. One study showed that mental and physical development was normal for infants exposed to fluoxetine in breastmilk in their first year of life. If you suspect the baby has any symptoms (such as irritability, vomiting, diarrhea, trouble sleeping, or trouble gaining weight) contact the child’s healthcare provider.

The product label for fluoxetine recommends women who are breastfeeding not use this medication. But the benefit of treating your condition might outweigh possible risks. Your healthcare providers can talk with you about using fluoxetine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes fluoxetine, could it affect fertility or increase the chance of birth defects?

Fluoxetine and other SSRIs have been reported to cause some sexual side effects, such as lower sexual desire or problems with ejaculation. This can affect a man’s fertility (ability to get a woman pregnant). Studies looking at fluoxetine in a small number of men have reported that sperm quality can be affected (but still within the normal range) with long-term fluoxetine use. The sperm quality improved when fluoxetine was stopped. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at http://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

This sheet is about exposure to amitriptyline in pregnancy and while breastfeeding. This information is based on published research. It should not take the place of medical care and advice from your healthcare providers. 

What is amitriptyline? 

Amitriptyline is a medication that has been used to treat depression, pain, tinnitus (noise or ringing sounds in the ear), irritable bowel syndrome, neuropathy (nerve damage) due to diabetes mellitus, and migraine headaches. Amitriptyline belongs to a class of medications known as tricyclic antidepressants. It has been sold under many different brand names, including Amaril®, Amitrid®, Elavil®, Endep®, and Vanatrip®. Amitriptyline has also been sold in combination with other medications. 

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

Pregnancy might affect how the body breaks down this medication. Some women might need to have their medication doses changed as pregnancy progresses.  

Some women could have a return of their symptoms (relapse) if they stop taking this medication during pregnancy. If you plan to stop this medication, your healthcare provider might suggest that you slowly lower the dose instead of stopping it all at once. Stopping this medication suddenly can cause some people to have withdrawal symptoms. It is not known if or how withdrawal might affect a pregnancy, 

I take amitriptyline. Can it make it harder for me to get pregnant?  

Studies have not been done to see if amitriptyline could make it harder to get pregnant.  

Does taking amitriptyline increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if amitriptyline can increase the chance of miscarriage. One study suggested that amitriptyline use to treat migraines might increase the chance of miscarriage. Untreated depression might increase the chance of miscarriage. More information on depression can be found in our sheet here: https://mothertobaby.org/fact-sheets/depression-pregnancy/.  

Does taking amitriptyline increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like amitriptyline, might increase the chance of birth defects in a pregnancy. A small number of human studies have not found a higher chance for birth defects with doses of amitriptyline used for treatment of depression. 

Does taking amitriptyline in pregnancy increase the chance of other pregnancy-related problems? 

It is not known if amitriptyline can increase the chance of other pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). One report found a small increase in the chance of preeclampsia (high blood pressure and problems with organs, such as the kidneys) when amitriptyline was used in the second and third trimester of pregnancy.  

Research has shown that when depression is left untreated during pregnancy, there could be an increased chance of pregnancy complications. This makes it hard to know if the medication, untreated depression, or other factors are increasing the chance of these problems.  

I need to take amitriptyline during my pregnancy. Will it cause withdrawal symptoms in my baby after birth?  

The use of some tricyclic antidepressants during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms seen during the first month of life included colic, low oxygen levels, breathing problems, and irritability. If a baby develops these symptoms, they usually go away in a few days without any long-term health effects.  

There is one case report of an infant who had temporary withdrawal symptoms after exposure to amitriptyline during pregnancy. The infant and the mother were found to have high blood levels of amitriptyline. Not all babies exposed to amitriptyline will have these symptoms. It is important that your healthcare providers know you are taking amitriptyline so that if symptoms occur, your baby can get the care that is best for them. 

Does taking amitriptyline in pregnancy affect future behavior or learning for the child?   

One study looking at 29 children exposed to amitriptyline during pregnancy did not find any behavioral or learning problems. 

Breastfeeding while taking amitriptyline: 

Amitriptyline gets into breast milk in small amounts. There are several reports of amitriptyline being used during breast feeding. No side effects have been reported in most nursing infants.  

There was one report of a woman who was taking 10 mg of amitriptyline per day while breastfeeding. The breastfeeding baby (15 days old) was reported to be very sleepy. When the medication was stopped, the infant’s sleepiness resolved.  

The benefits of using amitriptyline might outweigh the risks of an untreated medical condition. If you suspect the baby has any symptoms (being too sleepy), contact the child’s healthcare provider. Your healthcare providers can talk with you about using amitriptyline and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes amitriptyline, could it affect his fertility or increase the chance of birth defects? 

Some studies report amitriptyline lowered sex drive and caused sexual dysfunction in men, which can affect fertility (ability to make healthy sperm). These problems can also be side effects of untreated depression. Studies have not been done to see if amitriptyline could increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

This sheet is about eating raw, undercooked, or cold meats and seafood in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What are raw, undercooked, or cold meats and seafood?

Raw meat or seafood is any meat or seafood product that has not been cooked at all. Undercooked meat or seafood has been cooked in part but has not been heated to the safe minimum internal temperature. Deli meats (also known as cold cuts) and cold seafood are precooked meats or seafood that have been frozen or chilled for later use.

Raw, undercooked, or deli meats and seafood can contain bacteria and/or parasites that can cause foodborne illnesses. For this reason, it is recommended to cook meat and seafood up to at least the minimum internal temperature, and to reheat pre-cooked cold meats or seafood. See below:

More information on specific bacteria and parasites that can be found in foods is available in these MotherToBaby fact sheets:

• E. coli (https://mothertobaby.org/fact-sheets/e-coli-pregnancy/),
• Listeria (https://mothertobaby.org/fact-sheets/listeriosis-pregnancy/),
• Salmonella (https://mothertobaby.org/fact-sheets/salmonella-pregnancy/),
• Toxoplasmosis (https://mothertobaby.org/fact-sheets/toxoplasmosis-pregnancy/),
• Vibrio (https://mothertobaby.org/fact-sheets/vibrio-pregnancy/).

Methylmercury amount is another concern with seafood. Please see our fact sheet at https://mothertobaby.org/fact-sheets/methylmercury-pregnancy/ for more information.

I heard on the news that a product I might have eaten has been recalled. Is there a place I can check?

You can check for food recalls on the U.S. Food and Drug Administration (FDA) website at https://www.foodsafety.gov/. If you heard about a recall on the news, write down all the information from the news article and call the phone numbers or check the websites that they have provided.

There can be a chance of infection from food cooked at home that is not handled safely. You can learn about safe handling of meats and poultry on the consumer section of the U.S. Department of Agriculture (USDA) website: https://www.fsis.usda.gov/wps/portal/fsis/home.

How do I know if I have eaten raw, undercooked, or cold meat and seafood that is infected with bacteria or a parasite?

People can get sick from unsafe food handling practices from eating at a restaurant, on a cruise, on a trip, a home-cooked meal, or other food-related occasions. These situations are unlikely to get reported. Some people who become infected with bacteria or parasites show no symptoms. Others might have fever, diarrhea, stomach cramps, stomachache, headache, muscle pain, swelling of lymph nodes, joint pain, and/ or vomiting, depending on the infection. The symptoms can start hours to weeks after eating contaminated food.

If you are concerned that you have been infected with bacteria and/or parasites from meat or seafood,

Ask your healthcare provider if there are tests to diagnosis the infection. In some cases, there might be medications that can treat the infection and reduce the chance of harm for your baby.

Does eating raw, undercooked, and/or cold meat and seafood increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. If meat/seafood is infected with certain bacteria or parasites and a woman who is pregnant becomes ill from eating it, there might be an increased chance of pregnancy loss. High fever can also increase risks to the baby. For more information on fever during pregnancy, please see our factsheet at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.

Does eating raw, undercooked, or cold meat and seafood increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. When a pregnant woman is exposed to raw, undercooked, or cold meat and seafood, the chance of birth defects depends on whether the woman becomes infected and by which parasite or bacteria.

For example, E. coli, Listeria, and Salmonella have not been associated with a higher chance of birth defects. Infants born to women who had toxoplasmosis infection during the first trimester of pregnancy have about a 10-15% chance of being born with the infection themselves (called congenital toxoplasmosis). While the chance of passing the infection to the baby (transmission) increases later in pregnancy, most observed effects are seen with first trimester infection. Some infants with congenital toxoplasmosis will have problems with the brain, eyes, heart, kidneys, blood, liver, or spleen.

Would eating raw, undercooked, or cold meat and seafood increase the chance of other pregnancy related problems?

If food is contaminated with bacteria or parasites and a woman who is pregnant becomes infected from eating it, there can be other risks to the pregnancy. This can include preterm delivery (birth before week 37) or pregnancy loss.

Does eating raw, undercooked, or cold meat and seafood in pregnancy affect future behavior or learning for the child?

Toxoplasmosis infections can cause long-term problems for the baby, such as vision loss, hearing loss, or developmental delays. Many infected infants will have no problems at birth, but symptoms of congenital toxoplasmosis can happen months or even years after birth. For this reason, infants with congenital toxoplasmosis should be treated for the infection during the first year of life and then should be checked for problems over time.

Listeriosis infections are uncommon in newborns but can also increase the chance for long-term health complications in children. Newborns with Listeria infection can have symptoms of sepsis (blood infection) or meningitis after birth. Meningitis is a condition where there is swelling around the brain and spinal cord. If not treated quickly with antibiotics, the effects of meningitis can lead to long-term problems for some children.

Breastfeeding while eating raw, undercooked, or cold meat and seafood:

Breast milk can help protect a baby from infections. There have been case reports suggesting Salmonella might be passed from a woman who is breastfeeding to a nursing child. However, most people with these types of infections do not need to stop breastfeeding. Diarrhea and other symptoms of E. coli infection might lower milk supply. In the case of E. coli and Salmonella infections, be sure to practice good hand washing. If you suspect that the baby has symptoms, such as diarrhea, contact your child’s healthcare provider. Be sure to talk to your healthcare providers about all your breastfeeding questions.

If a man eats raw, undercooked, or cold meat and seafood, can it make it harder to get a woman pregnant or increase the chance of birth defects?

Although most people get Salmonella or E. coli from eating contaminated foods or animals, these infections can also be passed from person to person. Wash hands often to help reduce the chance of passing the disease among people living in the household. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information on paternal exposures, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references:

This sheet is about exposure to sumatriptan in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is sumatriptan? 

Sumatriptan is a medication that has been used to treat migraine headaches. It can be taken by mouth (orally) in pill form, by nasal spray, or by injection (shot). Some brand names for sumatriptan are Imitrex®, Alsuma®, Imigran®, Onzetra Xsail®, Tosymra®, and Zembrace SymTouch®.   

Sumatriptan is available in a combination product (Treximet®) that also contains naproxen. The U.S. Food and Drug Administration (FDA) states pregnant women should not use NSAIDs (such as naproxen) after week 20 of pregnancy unless specifically advised to do so by their healthcare provider. For more information on naproxen, see our fact sheet at https://mothertobaby.org/fact-sheets/naproxen/.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

Can having migraine headaches affect pregnancy? 

Some studies have shown that women with a history of migraine headaches have a slightly higher chance for pregnancy complications including high blood pressure and preeclampsia (high blood pressure and problems with organs, such as the kidneys), which can lead to seizures (called eclampsia), and pregnancy-related stroke. Be sure to talk with your healthcare providers about your history of migraine headaches so they can monitor symptoms during pregnancy, if needed.   

I take sumatriptan. Can it make it harder for me to get pregnant?  

It is not known if sumatriptan can make it harder to get pregnant. 

Does taking sumatriptan increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not found an increased chance of miscarriage when sumatriptan was taken during pregnancy.  

Does taking sumatriptan increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like sumatriptan, might increase the chance of birth defects in a pregnancy. 

Studies have not found an increased chance of birth defects when sumatriptan was taken during pregnancy.  

Does taking sumatriptan in pregnancy increase the chance of other pregnancy-related problems? 

Some studies have suggested a small increase in chance of some pregnancy-related problems, including preeclampsia, preterm birth (birth before 37 weeks), low birth weight (weighing less than 5 pounds, 8 ounces [2500g] at birth), and heavy bleeding after delivery if sumatriptan was used late in pregnancy. However, some of these complications (including preeclampsia, preterm birth, and low birth weight) have been associated with migraines in pregnancy. This makes it hard to know if the medication, the condition being treated, or other factors are the cause of these complications.  

Does taking sumatriptan in pregnancy affect future behavior or learning for the child?   

No studies have looked at sumatriptan by itself to see if it can increase the chance of behavior or learning issues in children. One study looked at behavioral effects in children exposed to any triptan medication during pregnancy (including sumatriptan). At age 3, these children did not show behavior differences, except for a small increase in behaviors that might be related to later attention problems. However, by age 5, this difference was no longer seen. This follow-up study also found no difference in communication problems, activity levels, or temperament traits (like shyness) at age 5. Based on these two studies, there’s no confirmed evidence of behavior problems. 

Breastfeeding while taking sumatriptan: 

Sumatriptan gets into breast milk in small amounts. It is also not well absorbed by the stomach, which further limits the amount that the infant is exposed to from the breastmilk. The product label for sumatriptan notes that avoiding breastfeeding for 12 hours after a dose of sumatriptan can decrease the infant’s exposure. This is a conservative approach that might be more helpful in certain situations, like with a newborn delivered prematurely. However, given the low level of medication entering the milk, sumatriptan is generally not expected to cause side effects, even when breastfeeding takes place right after taking the medication.  

One study found that some mothers reported pain in their breasts and nipples after taking sumatriptan or similar medications. Some of these mothers also reported a decreased milk supply. It is not known how often these problems might occur. It is also not proven that these symptoms are because of the medications.  

Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a male takes sumatriptan, could it affect fertility or increase the chance of birth defects? 

Studies have not been done to see if sumatriptan could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

This sheet is about exposure to laxatives in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What are laxatives?

Laxatives are medications used to treat constipation. Laxatives come in different forms. This sheet discusses over-the-counter (OTC) laxatives such as osmotics, fiber or bulk, stool softeners, stimulants and lubricants. For information about the prescription laxative prucalopride (Motegrity®), please see the MotherToBaby Fact Sheet: https://mothertobaby.org/fact-sheets/prucalopride-motegrity/pdf/.

Osmotics are laxatives that work by pulling water into the intestines. Examples of osmotics include salts, such as magnesium hydroxide (Milk of Magnesia®) and sodium bisphosphate (OsmoPrep®), and sugars, such as lactulose and polyethylene glycol (Miralax®). Osmotic medications are not well absorbed by the intestine, so very little is likely to get into the bloodstream of the person taking the osmotic laxative. This means exposure to the pregnancy is expected to be small.

Fiber or bulk laxatives include psyllium (Metamucil®) and methylcellulose (Citrucel®). Since these ingredients generally do not get into the bloodstream, pregnancy exposure is unlikely.

Stool softeners include docusate sodium (Colace®) and glycerin. For more information on docusate sodium, please see the MotherToBaby Fact Sheet: https://mothertobaby.org/fact-sheets/docusate-sodium-pregnancy/pdf/.

Stimulants include senna (Senokot®), bisacodyl (Correctol®), and castor oil (made from the seeds of castor beans).

Mineral oil is a lubricant. These products enter the bloodstream in small amounts, so there may be small exposure to the pregnancy.

Stimulants and lubricants may cause stomach cramps, which can be severe.

I just found out I am pregnant. Should I stop taking laxatives?

Talk with your healthcare provider before starting a medication or making any changes in your medication. It is important to consider the benefits of treating constipation during pregnancy.

Constipation may cause pain and other health problems in pregnancy such as cramps, hemorrhoids, and breakdown of the anal tissue. Treating constipation might help reduce the risk of these problems. While occasional constipation is common in pregnancy, talk with your healthcare provider if constipation becomes an ongoing problem. Your healthcare provider may want to confirm the diagnosis of constipation and see how dietary and exercise changes can help before discussing medical treatment. Dietary changes such as increasing fluids and eating high fiber foods such as whole grains and fresh fruits and vegetables might help prevent constipation. Regular exercise might also help.

I take laxatives. Can it make it harder for me to get pregnant?

It is not known if using laxatives can make it harder to get pregnant.

Does taking laxatives increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition, or other factors are the cause of a miscarriage. Studies have not been done to see if laxatives increase the chance for miscarriage.

Does taking laxatives in the first trimester increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background. Only a few studies have looked at laxative use during pregnancy. However, the available studies show that when used in recommended doses, over-the-counter laxatives are not expected to increase the chance of birth defects. Talk with your healthcare provider or contact a MotherToBaby specialist to discuss information on your specific laxative medication.

Could taking laxatives cause other pregnancy complications?

When laxatives are used more than recommended, they can increase the chance of complications. Laxatives can make food go through the intestines faster than usual, which can reduce the amount of nutrients that are absorbed into the body. For this reason, using laxatives too much or too often can increase the chance of nutritional problems. Using laxatives can also affect the way the body absorbs other medications you might be taking.

Using more than the recommended amounts of laxatives can also lower the levels of needed salts in the blood, such as magnesium. A reported case of low magnesium levels in a newborn was linked to the mother using too much docusate sodium during pregnancy. The baby’s main symptom was jitteriness, which went away by the second day of life.

Castor oil has been used at the end of pregnancy to try to bring on labor. Castor oil can cause severe diarrhea and cramping of the bowel and uterus, but these contractions are unlikely to bring on labor if the lower part of the uterus (cervix) is not ready for labor. If you are at the end of your pregnancy, your health care provider can discuss other ways to begin labor.

Does using laxatives in pregnancy cause long-term problems in behavior or learning for the baby?

Using laxatives as directed in pregnancy is not expected to have long-term effects on a baby’s learning or behavior.

Can I use laxatives while breastfeeding?

The medications in some laxatives might get into the mother’s bloodstream, but the amount that passes into breast milk is usually low. Mineral oil can get into the bloodstream and breast milk in greater amounts, so it should be used carefully.

There are occasional reports of loose stools in infants exposed to laxatives from breastfeeding. Contact a MotherToBaby specialist to discuss information on your specific laxative medication. Talk to your healthcare provider about all of your breastfeeding questions.

If a man takes laxatives, could it affect fertility (ability to get a woman pregnant) or increase the chance of birth defects?

There are no studies looking at possible effects on fertility or risks to a pregnancy when the father takes laxatives. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

MotherToBaby is currently conducting a study looking at functional constipation and the medications used to treat it in pregnancy. If you are interested in learning more about this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study.

Please click here for references.