Miralax is one of the most commonly prescribed drugs for infants, toddlers and kids. It was available by prescription only until 2006. Even then, it wasn’t FDA approved for use in kids. Despite this, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) heartily endorses its use in babies, toddlers, kids and teens. It contains ingredients found in anti-freeze. Concerns for its toxicity have mounted – which is warranted: One child in my practice slipped into a coma during an in-patient, closely monitored procedure to give high doses of the laxative ingredient in Miralax (polyethylene glycol 3350) to clear a fecal impaction. So many parents have voiced concerns for reactions to Miralax that there is even a Facebook group just for this, a class action lawsuit, and consumer advocates who have pressed the FDA for answers on how often and freely doctors place children on Miralax.
The label states it is only to be used by adults for up to seven days – but children have entered my practice who have been on it, with their gastroenterologists’ blessing, for years – which is not unusual. And when I meet these kids, they are still constipated, still unable to move bowels without drugs or suppositories, still picky eaters, and they don’t feel good. Their parents want them off Miralax, and so do I. Having messy, uncomfortable “applesauce” stools every day – or none, not to mention side effects like bloating, gas, or psychiatric changes – is not healthy.
Get More Help! Jump to my Peaceful Pooping e-book to tap deeper and more detailed strategies to quit Miralax. Includes access to my top performer supplements, herbs, and probiotics that I have used in practice. To jump right to my product picks, click here.
The Truth About Miralax Use
The truth is, besides reaching a dangerous level of toxicity for some children, Miralax does not treat causes of constipation. What it does do is turn stool into mush, by pulling more water into the intestine. Children can go from being impacted with hard dry feces – which is indeed uncomfortable or painful, and important to resolve, since this encourages toxins from stool to be reabsorbed – to expelling some mushy stool regularly. Even still, kids can be left with blobs of sticky festering fecal matter throughout the colon, despite using more, more, and more Miralax.
For kids on Miralax for a long time, a common problem that I’ve encountered in my pediatric nutrition practice is “overflow diarrhea”. In this scenario, blow outs of loose stool happen every few days, with or without firm, hard, or dry plugs of stool. This overflow seeps around impacted stool matter, causing staining in pants that kids (and even teens) can’t control. For toddlers, it can explode up the child’s back and and down to ankles. Many moms have described to me the daily chore of stripping kids down, bathing them, and getting fresh clothing because this pattern covers their toddlers or babies in stool. Older kids experience embarrassing stool accidents with this pattern. Needless to day, this is exasperating and concerning for parents – and miserable for kids.
There are other solutions! They are non-toxic, safe, and effective. My top three interventions for constipation are…
1 – Assess and clear fungal infections in the gut.
Prevailing thought in gastroenterology today dictates that fungal infections rarely warrant attention, unless a person is showing clear outward signs – like thrush at tongue, persistent itchy dry patches on skin, vaginal yeast infections, and so on. Even then, a topical medicine may be the only offering. People who are immune suppressed may also need anti-fungal medication. It’s hard for them to fight off any infection, and having a fungal burden makes this even harder. In that case, an oral dose may be prescribed.
It’s rare for a gastroenterologist to regard fungal infections in the gut as a problem or to prescribe an oral medication for it. A pediatrician usually won’t either. The belief is that fungal microbes (yeast, Candida, mold) are normal residents in human intestinal micro-biomes, and relatively harmless.
True enough – if there is little to no fungal growth in there. A lot of fungal microbial overgrowth is not healthy, and can cause problems like constipation, leaky gut, bloating, gas, sugar cravings, picky eating, or behavior issues especially in kids. Without testing stool specifically for fungal burden, this problem can continue unaddressed. Kids can have fungal infections in the gut while not otherwise showing signs like recurring rashes or thrush. Antibiotics, C-section delivery, prior thrush, and long term use of reflux medicine or steroids are just a few ways that a fungal burden can take a commanding posture in a child’s gut microbiome!
If your baby or child has had thrush – that is, a white coated tongue, or a diaper rash with white patches in stool – an anti-fungal medication may be offered, because thrush is a kind of fungal infection. But fungal load can persist deep in the GI tract, which, don’t forget, is several feet long. There is plenty of space between mouth and anus for fungal microbes to thrive. Yeast and fungal microbes can occur in the small intestine under certain circumstances, as well as in the colon. Just because the white coating on the tongue is gone, and the diaper rash too, does not mean the fungal infection is all gone. A lengthier course of medication can clear the problem, if it is lingering in colon or intestine.
Stool tests that screen for fungal dysbiosis are not routine in pediatric gastroenterology, but many functional medicine providers offer this test. I often use these in my pediatric nutrition practice too. Why? Because fungal overgrowth in the gut can be very constipating. A simple but thorough treatment with anti-fungal medicine may fully resolve years of Miralax-dependent constipation. I have observed this many times in cases where a patient’s prescribing MD was willing to give it a try. Anti-fungal medications like Nystatin or azole antifungals can do this.
There are few anti-fungal drugs available, which is one reason why doctors are hesitant to use them unless they really have to. They don’t want resistance to develop against these drugs. But if a child is so constipated that they’ve spent years unable to eliminate normally or painlessly, they suffer side effects from Miralax, or they can’t eat well, grow, or thrive, and quality of life is greatly compromised, then your doctor may be willing to help.
Herbs can help keep fungal infections cleared out too. Common tools include tinctures or capsules of oregano, thyme, grapefruit seed extract, goldenseal, berberine, uva ursi, caprylic acid, black walnut, garlic, undecylenic acid, and many others. Capsules and liquid tinctures are available – these are best used with guidance. See my e book Peaceful Pooping for more details, and set up your own access to my nutrition dispensary here to browse.
Olive leaf extract has activity against fungal strains like Candida albicans.
Probiotics can often resolve milder constipation. But for kids with a longer history of constipation severe enough to require clean outs and medication, I have not found probiotics alone to be effective. Combining a probiotic regimen with herbal or prescription treatment can work best.
Here’s a clinical pearl: A popular probiotic used for intestinal fungal infections is Saccharomyces boulardii (“Sacc B” for short). I see most success in my pediatric nutrition practice when using this short term, that is, for 2-4 weeks. Sacc B is itself a yeast species. When used for longer periods, in my experience, it starts to act like more of a burdensome fungal microbe than a helper. An ideal product for this is Klaire Labs ABx Support. You can join my professional grade FullScript dispensary here to view this product.
While Miralax is not FDA approved for youngsters, anti-fungal medicines like Diflucan and Nystatin are. They can do a good job of clearing constipation from fungal infections. Explore this with your doctor if your child has been constipated for a long time.
2 – Lose the reflux medicine!
Fungal infections worsen reflux, and reflux medicines worsen fungal infections. Click here for more on why you don’t want to leave your child on reflux medicine for very long.
Like Miralax, reflux medicines are widely prescribed for babies and kids – some say over prescribed. Prilosec (omeprazole), a proton pump inhibitor (PPI) reflux medicine, is one of the top ten drugs prescribed in the US. The FDA has not approved PPIs for use in infants or children, unless a diagnosis of erosive esophagitis has been made (this requires endoscopy). Still, I routinely encounter infants and toddlers in my pediatric nutrition practice who are given reflux medicines with no diagnostic testing. As is often the case with Miralax, kids stay on these drugs for months or even years. This will worsen constipation and exacerbate fungal infections while lowering digestive function overall. Using reflux medicine long term reduces absorption of many nutrients, especially minerals, protein, and B vitamins. I have had some cases in my practice in which children who used reflux medicines for over a year suffered fractures, and others have experienced stunting and delayed bone age. They were not absorbing minerals or protein normally, and could not grow bone as expected. The FDA has issued a warning about elevated fracture risk in adults using reflux medicines. The same problem has been noted in children.
Talk to your doctor about weaning off reflux medicine if your child has used it for more than a month. There are many ways to improve digestion and diminish reflux without drugs. Changes in foods and use of herbs can gently enhance your child’s digestion while you wean off a reflux medicine. Correcting the gut micro-biome will help as well. Do this with guidance for better, faster results.
3 – Use Magnesium.
This one is so simple. Magnesium is an easy way to pull water into the gut without toxic effects from peculiar ingredients in products like Miralax (dyes, gluten, polyethylene glycol). Magnesium oxide is a stronger laxative than magnesium citrate; magnesium citrate is stronger than magnesium glycinate. There are other forms of magnesium besides these three, and depending on your child’s presentation, there is probably a magnesium option that can help wean off Miralax. A product called Mag O7 is easily available. It’s ozonated form of magnesium that has worked well for some of the most constipated children in my practice. But take note!! The label instructions are intended for adults. This dosing is too high for most children. Safe upper limit dosing of magnesium for a 40-80 pound child is only 350 milligrams (mg) of magnesium. For smaller children, even less may be all that is needed. Check with your health care provider and pharmacist before using this product, to make sure it can be safely used.
Besides drawing water into the colon, magnesium is calming. It can help with sleep, mood, muscle cramps, or may even fix heart palpitations or arrhythmias. This is great, but too much is sedating and may slow heart rate. It’s best to use magnesium with guidance, especially for infants or young toddlers. I choose which product and what dose, based on each child’s case. There are liquids, powders, and capsules of various magnesium products. One of the most popular is Natural Calm, available on many supermarket store shelves. A two teaspoon gives 350 milligrams of magnesium citrate. This is too much for a baby or toddler, but may be perfect for a school age child weighing more than 40 pounds. More than two teaspoons daily is not likely to be necessary and may be too sedating for any child. If you have any questions about using these products, especially if your child takes other medications, ask your pharmacist or pediatrician.
These three ideas are only the beginning. From foods to herbs to drug-free options, there are many ways to clear constipation that are not only non-toxic, but more effective than Miralax – and they create better overall health by replenishing nutrients, building a healthier gut microbiome, and eradicating the cause of constipation. For even more help, check out my e book on Milk Addicted Kids (another constipation situation!) and stay tuned for Peaceful Pooping, my upcoming e book and protocol on getting off Miralax. Thanks for stopping by!
Hello, my son has been on Miralax for 3 months now, and I have read stopping cold turkey could cause damage. Do you have a recommendation as I am trying the three items listed on how to get him off the miralax? Is it to slowly do less and less?
Hi Jordan, I agree that stopping Miralax without providing other support can backfire. If you have added a support other than Miralax, like any of the three suggested here, you can slowly reduce Miralax as you notice stool becoming more runny or wet. You may not need all of the items suggested here at once and in fact it’s ideal to introduce one at a time. Any one of these alone may do the trick. Stay tuned on may social media or newsletter for a new release e book from me soon, with more detail and more options on moving on from Miralax.
Judy, My daughter is wanting to take my 3 year old granddaughter off Miralax. Some sites are suggesting an elimination diet to get all of the Miralax out of her system. Do you recommend this and what would be the best gut diet for a 3 year old?
I’m going to guess that the sites recommending diet eliminations say to avoid gluten, dairy and sugar. Though that can be beneficial, it has to be based on that individual child’s needs. And, all that food has to be replaced with something of equal or better nutrition value. A nutrition assessment will clarify if those foods are behind the constipation. To see why they so often are, check out my e book on milk addiction in kids (which goes hand in hand with constipation). If foods aren’t part of the problem, usually the gut’s microbiome is – and that may need support too. This is were probiotics are handy. Ask your pediatrician what they suggest. A higher than usual potency is often needed to resolve entrenched constipation and help kids leave the Miralax behind. I often use these in my pediatric nutrition practice, but hesitate to make a suggestion here without knowing what your granddaughter needs. There is no best-gut-diet for a three year old per se – all has to be based on that child’s growth pattern, bowel habit, food intake, history for infections or allergies, and often times, lab data is needed to sort it out.
My son (11yo in 3 weeks) has S.P.D. , Anxiety, Feeding issues (due to texture avoidance)., and Transient Tic Disorder.
He has had stomach issues off and on since starting solids. He had recurrent ear infections which stopped after having tubes put in as a toddler, he is HIGHLY allergic to several antibiotics (hence the tubes!), had yeast infections due to the antibiotics, has Intrinsic Asthma so he used to be on inhaled steroids off-and-on (thankfully mostly off for the last 3 years now!). He also has a strong family history (myself, my sister, and my mother) of Ehlers-Danlos Syndrome, which can affect the intestines and their function.
He ended up severely constipated (with a blockage) and at the ER twice (2 weeks apart EXACTLY). The first trip granted him an enema, which apparently didn’t clear the blockage. The second trip, the blockage was worse and we had to do a Miralax cleanse the next day – which thankfully cleared him out!
After a referral to a pediatric G.I., he was put on Miralax daily for 3-6mo. I recently noticed his tics were slowly getting worse, and this weekend they peaked to the point where I was about to call for a Neuro referral and put him on medications for them. I just happened to do a little research on my own, found out the issues with Miralax and children with tics, and called his G.I. yesterday. They called me back today and said they looked into it and to stop the Miralax IMMEDIATELY as it can indeed cause these issues and to switch him to Milk of Magnesia.
Do you know how long it should be for his tics to calm back down? Should I get him into a neurologist to follow the healing from the Miralax (I feel HORRIBLE!)? Is there something else I can give him besides liquid MoM? He HATES liquid! I have a feeling his gut bacteria is way off, do the antibiotics off-and-on and the food issues, combined with the Miralax cleanse…anything you would recommend to help get his gut healthy again??
Your son’s features for SPD, tics, anxiety, texture avoidance, and constipation are all quite possibly linked to his gut biome status. This is treatable in the functional medicine model. This approach uses stool testing to identify the status of the microbes in the gut, and the status of the digestive functions. Balancing and correcting these is a potentially very effective way to dramatically improve or even fully resolve these features – yes, all of them. There may be other pieces in the mix for sure, including unmet nutrient needs, total calorie needs, or other issues with total diet. But, the gut biome is the place to start, and the conventional approach your providers are using is a bandaid for the end stage symptom of constipation. It doesn’t address root cause and won’t change much of anything, other than make mushy stool that he may be able to expel more easily. This can be a great help in a pinch but long term, as you’ve observed, side effects and/or new symptoms are common, in my experience. For details on how to work through gut biome take a look at this book or this blog for some ideas to start with.
my 3 year oldmy granddaughter has been on miralax every day for about 6 months. she has lost weight and complains that her stomach is hurting and she dont want to take this medicine anymore she knows that she is not feeling normal on this medication the parent which is the mother will not listen to anything ive told her about the danger and very life threatening danger this medication can cause for christ sake it has antifreeze in it im desperate and dont know what else to do my granddaugher has gone as far to say she has been peeing out her butt..im a very concerned grandmother whom loves my grandaughter very much the weight loss the abdominal cramping and loss of electrolites is very concerning since its not recommended for children . please help
Hi Laura, sounds like a difficult situation indeed. Unless your daughter is willing to consider a different approach, there isn’t much you can do. There are safe and effective solutions beyond Miralax, perhaps you can start by sharing this blog with her and encouraging her to let the doctor know that the medication seems to be failing.
Hi Judy. My 2 year old daughter was born with an imperforated anus. She had a colostomy for 6 months whilst we waited for the pull-through surgery. Her colostomy has now been reversed but she has ongoing issues with constipation as a result of her weaker bowels and muscles (although she has a sphincter so should hopefully have no issues with incontinence).
We tried lactulose for a whole but it didn’t help so she’s on Miralax now (or movicol as we’re in the UK) and it is doing the trick and stopping her from getting constipated. But I worry about the long-term use of it and would love to find a safer, healthier alternatives.
Is there anything you can recommend which I could try to gradually help reduce the miralax? Or should I just accept that, with her condition, if it works it’s the best thing for her right now?
There are a number of options to soften and bulk stool so it’s easier to push through the colon, besides Miralax, which softens stool to mush. A normal stool consistency – soft formed – is easiest for the colon to move and push along. Wet mush is difficult to squeeze. I’ve had many clients who have had impacted stool seen on Xray with “Miralax mush” dripping around it. Ideally all waste should be expelled and stool should not sit in the colon in any form, day after day. Magnesium citrate, vitamin C, ground flax, chia seed puddings, and psyllium powder are a few ways to bulk and soften stool. Eat a diet rich in fresh fruits and vegetables like asparagus, lentil stews or dahl, cauliflower, broccoli, apples, banana, kiwi, blueberries… Eat raw juiced fruits in small quantities with fresh mint or cilantro or fresh squeezed grapefruit juice added to help move and cleanse bowels. Use a few servings every day of these foods, and go light on dairy, grains, red meat and eggs.
Cultrellle with fiber for kids has been a life saver for us, my grandson has ASD and has fought constipation early on, his primary doctor suggested this a couple years back and it has help greatly!!!
Hello, my daughter is 5.5 years old ever since my wife decided to shock her into taking off her diaper (I did not agree with it) she’s been suffering from constipation. She’s been on and off on Restorolax (Miralax in the US) since March 2019 as per her Pediatrician, of late she was on 1/2 to 1/4 cap. We are trying vegetables (she hates them) but obviously we don’t want Restorolax any more. We just stopped it yesterday and we are trying natural, prune juice etc. and fruit and veggie shakes. We just want her to be regular. We are hoping she will go naturally. Any advice if she doesn’t go? She went yesterday but not today which is her first full day or so without Restorolax. I’m confused about the Magnesium in your post – how do I know it’s safe? Thank you!
Hello Ali. First order of business is to get on same page as parents. Resolve the conflict and resentment over the misstep around toilet training. Once there is a harmonious vibe around this in your household, your daughter can follow suit. Children are masterful sponges and soak up even the unspoken tensions in a home despite all our best efforts as parents. Meanwhile ask your doctor about magnesium dosing. Generally a 40-50 lbs child can safely use a 150 mg dose for magnesium citrate. Without guidance, do not exceed 300 mg daily. Review this with your doctor.
Probiotics are a must and also Fiber supplements high in Fiber has helped me tremendously with my child. Still looking into the Mag07 n really grateful for the insight about candida in the GI tract…haven’t stumbled upon that!! Still a working progress but the probiotics and high fiber helped us get rid of the poisonous Miralax!!!
Hi I have a 3yr old currently on miralax. What fiber and probiotics supplements do you use?
Hello. My daughter (5) has been on Miralax for over two years. We have several caps day and 1-2 major weekly clean outs with increases Miralax. She also currently on Natural Calm gummies, Senna, dulcolax every other day and those days are alternated with Milk of Magnesium. We have had very little success and nothing lasts. After a clean out her leakage returns within 2 days. Wr have been on FODMAP for 3-4 weeks in the elimination phase.
We have seen two specialists, in addition to our pediatrician. I have been thinking of trying Mag 07. So, I guess that is my next step.
Question: Where is your practice? Are you taking new patients? At this point, I would be willing to try anything or travel anywhere.
Thank you!
Mag 07 is a great tool but the label gives dosing for adults, not a child. This degree of constipation should be addressed for its root cause rather than chased with chronic laxative use and stressful clean outs. First suspects are intestinal Candida overload, and picky eating for wheat, soy protein, dairy food, or pea protein concentrates (Ripple Milk, Kate Farms Standard Formula, protein powders that are vegan). I will soon have more services to accommodate more families, and remote services (zoom chat, zoom appointment, and DIY modules) are on deck. Stay abreast at my FB page or subscribe to my newsletter for update on when to book.
Reading over the comments and your article, would it be enough to give my 3.5 year old the “Klaire labs vitalzymes chewable” to see if that helps him have daily, softer poops?
He was diagnosed with GBS from birth and had heavy antibiotics for two weeks in the NICU, assuming that is the reason for his GI issues, and thus has been prescribed constant Miralax. He’s slight, but very active 32 pounds, thank you in advance for your response.
It’s reasonable to try the enzymes unless you have knowledge of ulcerated tissue in your son’s digestive tract.
Hi My son is 3.5 and has been using miralax in some level for about 8 months. He was always constipated as a baby and basically lived on prunes for his first year and a half, then when we started potty training he started holding so we started using miralax to help force a go (we never forced him to do it on the potty we were always happy if he just went at night in his diaper and just celebrated the potty goes more) Now he does mostly use the potty but he still has trouble and never asks to go just sits at night and will go and then will still sometimes go in his night diaper. He is a good eater, actually likes brussel sprouts, asparagus and broccoli and eats a frozen prune puree popsicle every night plus fiber gummies but anytime we try and lessen the miralax he starts skipping days (he has about 1/2cap every other day sometimes full cap if it’s been over a day or two without pooping). Any suggestions?
I suggest using tips in this blog such as magnesium, probiotics and herbal antifungals to clear species that are constipating. Otherwise if you son is a big milk drinker, yogurt eater, cheese hound, or wheat eater (pasta, bread, starchy cookies and crackers) these will be constipating foods if they are not digested enough. You can remove these from his diet and choose replacements without those proteins (eg, without wheat which is gluten, and without milk protein which is casein) or you can try a chewable enzyme like Klaire Labs VitalZymes to see if this helps soften stool.
Hello,
My daughter has been on Miralax since about 6 months and she is 3 years old now. We tried to get her off miralax many times but it has not been successful and she gets severely constipated. After reading these comments, I’m wondering if this is related to use of Ranitidine (Zantac) in her first year of life, which was prescribed by her doctor. She has been off of that since 13 months, but what do I need to do first to start getting her off Miralax? I’m thinking somehow get her gut health checked and then use a daily probiotic and magnesium if need be? I’m so desperate to get her off of this, but I want to do it the right way and no cause her any pain or permanent damage.
Hi Heather, yes reflux medicines can lead to constipation: Reflux medicine makes it harder and harder for beneficial gut bacteria to grow, and harder for food to be digested. This leads to “dysbiosis” (altered gut bacteria that are not helpful or supportive of digestion), as the poorly digested food moves along the intestine, and feeds/favors the wrong bacteria. Probiotics and magnesium can help, ask your doctor for guidance if you’re not sure how, or try the steps in this blog post.
Hello my question is my 2 year old has been drinking Miralax for about 4 months . There was a day his poop got stuck and I would have to help him get it out . It was so heart breaking see him go through that. I decided to take him to the hospital and they told me Miralax will be the solution . Until now there are days he cannot Poop so I give him the Powder right away because I’m afraid he won’t be able to poop. I’m tired of giving him that since I know it’s not healthy for him to take at a young age . Is there something else appropriate for his age I can replace it with. I would appreciate so much. I’m tired of taking him to his pediatrician I’m telling me it’s normal . Which I think it’s not normal .
Try suggestions in this blog post. Other helpful tools for babies abound, but are best used with professional oversight. Your pediatrician only knows how to use prescription drugs or over-the-counter drugs, but is not trained in non-drug tools. Look for a naturopathic doctor (ND) in your area. These are doctors trained in the use of herbs, nutrition, and natural non-drug substances. There are many safe laxative options for babies besides Miralax, and a naturopathic doctor would know of these. Visit the American Association of Naturopathic Doctors for more info.
Hi Judy! My son is 2.5y/o and suffers from GI problems since newborn. At age 1.5 I was prescribed miralax every day. I asked for something natural and told me No. I use, for myself, mag07 and is amazing. I’m not sure the amount for his age though. He is 34 pounds. I don’t want to give him too much. Would you help me with that? Thank you!
I have used Mag07 for children but it is quite a high dose. For his age and weight you should not exceed 1 capsule without guidance. There are other magnesium formulations I prefer for toddlers that are easier to use, such as liquid suspensions that have a 2:1 calcium to magnesium ratio. The magnesium in these is typically magnesium citrate. Brands like BlueBonnet, MRM, and Integrative Therapeutics fit this bill nicely.
Another resource for your readers would be the Facebook group parents against miralax; there are over 40k members and many of them are sharing the exact same stories I.m reading here in the comments. Your article gets shared with some frequency in the group. Thank you for putting this together.
Thanks Mike! Have heard of that group and am glad these resources are out there.
hello, my son is 4 years old and has been dealing with constipation ever since i took him off of breast milk at 14 months and switched him to cow milk. The first 2 years it wasn’t as bad as it is now he just wouldn’t poop as often. The doctor told me to take away his milk and prescribed me an over the counter laxative. It became that he would only be able to pass if i gave him the laxative. I cut back on his milk instead. l also changed his diet and still. I stopped giving him the laxative because that’s the only way he would use the bathroom. Now he can go up to 2 weeks with out pooping and when he does have to he tries to push and push for days maybe even a week before he can pass. His doctor recently prescribed me miralax to try to help and that has become a nightmare. I cut off cow milk completely when we started miralax. it’s been a month now and everything that has been described on this page has happened to me with miralax. i can’t get my child to stop popping it’s an explosion every other hour. I don’t know what to do anymore. I took him off the miralax. May you please help me, may you please give me some herb options and probiotic options to help. Or what do you think I should do ? I just want my child to be able to use the bathroom on his own comfortably and not every 2 weeks!
Oh my goodness. Sometimes I wonder: If I did as poor a job as this pediatrician did, I’d be fired. So, firstly, I’d suggest you fire your pediatrician and find one who believes that children get to be healthy. That includes comfortably pooping mostly every day. If you have already tried the steps in this blog post and have had no luck, I’d find a naturopathic doctor (ND) in your area and seek advice. NDs are trained in the use of herbs, supplements, and foods – not drugs – to support health, and are interested in resolving root cause, rather than masking problems with drugs. You can start here to locate one near you. Interview them and ask about their experience with children and your specific dilemma. I am not taking new patients at this time, but otherwise would be glad to help. You can stay abreast of new offerings by following my facebook page here or signing up for my newsletter.
Hi my son is 14 months old and has sensory issues, constant constipation (since 6 weeks old), and had very bad reflux from birth until 11 months. He was on ranitidine for about 6 months before I switched to gaviscon for 3 more months. He had antibiotics at birth and has had antibiotics 3 times from 6-11 months for recurrent ear infections. He’s been on bia giaia probiotics for 8 months. I tried stopping them at 10months but digestive system went haywire so I got him back on. He had thrush and I treated it with nystatin liquid for a couple weeks although that purple stuff worked better for the thrush. I gave him olive leaf for 3-4 weeks to treat suspected yeast. The problem is he’s still dealing with constipation and I give him prune juice almost daily to get him going. To me it seems like he can’t relax to poop or maybe it hurts, and when he holds it in it gets harder to move. I am struggling to feed almost everything because of sensory issues. Is there any thing else I can do to help?
Is your son relying often on milk protein (yogurt, milk, Pediasure, cheese, etc) or wheat protein (cereal, bread, crackers, etc)? If so then he is likely not digesting this completely. Those proteins will trigger constipation if poorly digested. Given his long history of using drugs that weaken protein digestion (reflux medicine) it’s likely this is a factor in his case. Also he likely still has fungal dysbiosis in the digestive tract. A little low dose probiotic and a little olive leaf won’t do much good to get rid of this. He may need a 2-3 week course of a stronger drug like Diflucan or a longer rotation of herbal antifungals to move past this.
He does rely a lot on bread. I removed cows milk almost completely from his diet because I blamed it on his acid reflux problem and respiratory issues. He drinks almond milk. He is doing better without it. I don’t notice belching and indigestion as much anymore. How do I help him digest proteins? He does eat blended meats like cooked chicken and beef. He loves peanut butter sandwiches. Can I just ask his doctor to check for fungal dysbiosis at an upcoming appointment? She knows about his constipation issues.
Hi! I’m 14 years old. So when I was 12 almost 13 I had a rectal prolapse and had to go the hospital and soon after the prolapse went away they gave me miralax. I’ve been taking miralax ever since. I have just seen what can happen to me if I continue to use miralax and I do not want my body to become dependent on it. I’ve been using it for about a year and a half and I want to know what I can do to stop taking this. My biggest fears is when I stop taking this is that my prolapse will come back and I will gain weight because since I am able to use the bathroom more easily, i have lost weight. I do not know what to do and any advice will be appreciated.
Good for you for taking charge of your health at a young age. Keeping yourself comfortably pooping every day is important, and you can use alternatives to Miralax as described here, but it would be best if you did this with supervision from a health professional. That way your total nutrition picture can be evaluated, this might yield some other clues and opportunities for avoiding Miralax dependency for you. If your family would like to work with me, you can reach out at 720-727-7105 for an appointment.
Hello! I have a 19 month old daughter who has struggled with constipation since she started solid foods. Her pediatrician recommended miralax everyday. I hate the thought of giving her anything everyday…especially miralax. We can’t figure out the perfect dose because she will not go for days even with the miralax and then she has poop explosions for days. I really want to ditch the miralax. I was happy to read that you recommend magnesium. I try to take magnesium regularly. I’m not always successful…I need to do better. My daughter still breastfeeds so do you think the magnesium I take is enough for her too or should I try giving her more? Also, she was born by c-section and has been on antibiotics a number of times due to ear infections, so I’m worried there may be an issue with her gut health. I give her a probiotic everyday. I am open to suggestions. Thank you in advance for your help.
***In case it matters, the magnesium intake is a magnesium chloride and her probiotics are natren life start.
Your daughter has this problem because of the antibiotics. This favors a fungal overgrowth in her digestive tract. That is very constipating. A probiotic won’t fix this. Ask your doctor for a 30 course of oral Nystatin, and use the probiotic along with that. This will start to literally move her digestion in the right direction. It’s so amazing to me that doctors quickly give such young children Miralax – a drug not approved for that age group – and will tell you it’s ok to use it indefinitely – but will refuse the simple, safe, FDA approved drug that you only need to use once to actually fix the cause of the problem. Nystatin, an old, safe drug for intestinal Candida, can do this.
Hi! My daughter is 2 years old and we gave her somewhat irregularly macrogolum 4000 since she was 18 months. She suffered some days of withholding and very hard stool after we let her off the macrogolum. Now she has a lot of fear and tries to withhold as long as possible. We live in Switzerland so doctor’s say it’s safe to give her macrogolum. With a high dose of it she has stool every day now, but we feel there should be an alternative natural solution. She weights 11,7 kg and is now 28 months old. We mostly eat a Paleolithic diet. Can you advice us on an alternative to macrogolum? Thank you!
Hi Erika, I do believe that Macrogol 4000 is not approved for children under age 8 years. Hopefully you had help from your doctor in using it, but now that it hasn’t worked anyway, it is time to move on. There are many natural options, some described here, and I would start with those. If you are eating a mostly Paleo diet, one possibility is that she is eating too much protein for her age and stage, and not enough carbohydrates that build good gut flora terrain. That, in turn, aids stooling. In this forum, I can’t give specific advice beyond what is in this blog, but if you’ve tried that and would like more help, you can schedule with me by accessing my calendar here.
Hi Erika, one thing that catches my eye is your mention of Paleo diet, which is usually high protein, high fat, and low carb. Your daughter doesn’t need more than 40 grams of protein daily from all sources, and at this age, nearly half her food intake should come from carbohydrate foods (vegetables, fruits, tubers, legumes, and grains – the latter two are eliminated on a Paleo diet). If she is eating more than 40-50 grams of protein every day and eating little carbohydrate, this can worsen constipation for her. Toddlers need varied and nutrient dense carbohydrate sources to help build the gut biome terrain needed to aid digestion. For advice tailored to your child beyond ideas mentioned here, let’s set up an appointment to work one on one. You can click “work with Judy” above to get started.
My daughter has battled reflux/GI issues since birth, she’s now 5 years old and has regular stomach aches, night time nausea/gagging, is a picky eater, etc etc etc. The pediatrician eventually sent us to a GI who prescribed Miralax right away to help her have full bowel movements. They have done blood panels, tested her stool and have done an upper GI endoscopy to find the source of her problems and every test comes back normal. She has been on Miralax for 9 months now with no end in sight–whenever I try to wean her, she immediately gets backed up, turns pale & her energy drops before having a bowel movement (along with her other persisting stomach issues). Her pediatrician did recommend Natural Calm (in response to some hyperactivity) but the GI was more inclined towards staying on Miralax. I’m looking for any way to have her OFF the Miralax and using only natural products. In the long run I’m looking to get her systems working normally on their own, of course.
My question is if I want to switch her Natural Calm, do I need to drop the Miralax first or do I use both at the same time while weaning her from Miralax?
Your story is the exact same story hundreds of parents have shared with me. It’s reassuring that usual screenings are normal (they always are), but they won’t pick up what is likely causing your daughter’s problems: Gut dysbiosis. She likely has a fungal overgrowth in her colon or even in her stomach or upper small intestine, caused by the short term solutions she used too early and too long, like reflux medicine and Miralax. This circumstance reliably causes very poor picky appetite, and constipation. You can use magnesium with or instead of Miralax if you like, but to really solve her problems, you need to get rid of the microbial and fungal overgrowth I would bet is in her digestive tract. Your pediatrician and your GI doctor do not believe these warrant intervention (obviously, they would have done so already if they did). But, they do. A 30 day oral course of Nystatin might solve the entire problem for you. Ask your doctor.
Thank you for your reply! After reading this article and reading through the comments I talked to our pediatrician again about specifically targeting the fungal overgrowth. She has had many signs of a yeast overgrowth since infancy but those issues were never discussed in regards to her GI issues. Her doctor prescribed us the Nystatin. Along with that and a daily probiotic she has now been completely off the Miralax for over a month at this point! Her last (and final) GI appointment confirmed she was doing well and her bowels were not backed up. Her GI even admitted that she had never heard of these treatments…I’m so thankful to finally feel like I’m in control over my daughter’s health again. THANK YOU!
Your story is the exact same story hundreds of parents have shared with me. It’s reassuring that usual screenings are normal (they always are), but they won’t pick up what is likely causing your daughter’s problems: Gut dysbiosis. She likely has a fungal overgrowth in her colon or even in her stomach or upper small intestine, caused by the short term solutions she used too early and too long, like reflux medicine and Miralax. This circumstance reliably causes very poor picky appetite, and constipation. You can use magnesium with or instead of Miralax if you like, but to really solve her problems, you need to get rid of the microbial and fungal overgrowth I would bet is in her digestive tract. Your pediatrician and your GI doctor do not believe these warrant intervention (obviously, they would have done so already if they did). But, they do. A 30 day oral course of Nystatin might solve the entire problem for you. Ask your doctor.
Can I use magnesium along with lactulose?
I’m not aware of a contraindication for these, but check with your doctor and your pharmacist to be sure.
Judy, I very much appreciate the educational article/blog you wrote. My 9yo son suffers from encopresis, and his doctors all favor the band-aid approach. His symptoms ebb and fade, but mainly just keep him uncomfortable and embarrassed. As a result, our entire family has been enduring this plight with him all in our own different ways. I need help to help him before his side effects cause too much irreparable damage. A private e-mail as opposed to public commentS would be the preferred method of communication for me, if you do not mind. Again, thank you for imparting your knowledge upon us average folks just searching for an answer to our worries.
Hi Eva, sounds like you are ready to begin nutrition care. To work with me privately, you can reach my assistant at 720-727-7105 to get on my calendar.
Hello Judy,
My son is 15 and has been on Miralax for about 12 years. We went to a specialist when he was younger and they said he would probably out grow his constipation just like the family doc kept telling us, but to use Miralax to help his bowels in the meantime. We did and he was very consistent on the MIralax. We would like for him to get off of it tho, but everytime we try to wean him off constipation comes. Last year we had an ER visit because it flared up even on the Miralax. He is still having bowel movements everyday even when he has some impacted. They suggested a specialist again so we went. They did a rectal test on him which led to bio-feed therapy. It seemed to help and we finally got him off of Miralax, but then 3 months off of Miralax he was backup. He drank Magnesium citrate got most of it but then had to be give an enama. He was fine again, still no Miralax , but then 3 weeks later he seems to be impacted again. Gave him mag. citrate again but still seems to be impacted. (He says he is still going 2 or 3 times a day, but soils only at night). We are at our total whitts end with this. We have even started him on fiber tablets everyday along with acidophilus. My question is would the powder magnesium maybe be more beneficial on a daily basis like we did the MIralax. Thank you
Hi Darla, it boggles my mind that our pediatricians expect kids to live this way, for years – ! Your son is a trooper and deserves to feel better and to not even have to think about pooping. If this problem won’t go away, assess his gut microbiome for Candida. Your pediatrician and specialist GI will not do this – if they did, they already would have (I’ll bet that if they even did a stool study at all, all you heard was “everything was normal.”). You will need to work with an integrative practitioner for the correct type of stool study that looks specifically for fungal species (several, not only Candida), quantifies them (versus just saying positive or negative), and identifies both herbal and prescriptive agents to kill it. Many of us offer this in our practices, as I do. Next if your son loves to eat a lot of dairy and wheat foods, these may also be part of the problem. That also needs some assessment and strategy with a good integrative practitioner who knows how to feed growing teen boys. That’s me, so if you would like more help, set up a new visit series anytime and we can get started.
Hello Judy,
Thank you so much for posting this article. I hate Miralax. My daughter is 10 years old. She has had contraption issues off and on since being a toddler. It is not often, but when it does occur, peads are always pushing Miralax. I would like a natural remedy for her occasional constipation that works quickly. Miralax has taken days to work sometimes. This past time she was constipated for a week or so and it took Miralax 4-5days to work at 2 capfuls a day. She started having chest and leg pains. She has always had withholding problems in fear of pain even when on the Miralax. The Miralax finally worked but she is still having mushy stools 3 days after I stopped the Miralax. Is that normal? Does watermelon help pull water into the colon? Should she be drinking a certain amount after each meal? Can you offer other natural options for her that work quickly when she is in a bind. Thanks so much.
Have you tried the suggestions mentioned here so far – magnesium citrate, or using an herb to drop fungal (aka, yeast or Candida) in the gut? Start there. You can also use high dose vitamin C as a laxative. Start at 500 mg, and increase to bowel tolerance. There are liquids, chewables, lozenges, or pills that make this easy. Another natural tool is MCT oil or C8 oil. These come from coconut oil (which by itself doesn’t work well as a laxative) and are naturally laxative. Start with a small dose (1/2 teaspoon) and increase to bowel tolerance. Once stool flushes out, use a lower maintenance dose every day to aid stooling. Use liquid MCT or C8 oil (also called caprylic acid) – not capsules, pills or powders, and not whole coconut oil. Many brands are available for these oils. If these tools don’t cut it, you can set up a new patient series to work with me so we can get to the bottom of it once and for all.
Hello Judy, I am attempting a Vitamin C cleanout for my 3.5 year old. how often should I give 500mg? every Hour? Also – can I alternate with this product even though it has sodium and sugar in it? https://www.amazon.com/gp/product/B006H9R1KA/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1
I can’t make product and dosing recommendations here beyond what’s in the blog post. Young kids may not need more than 1000 mg of vitamin C to clear bowels, this truly depends on the individual’s circumstances. You can start with low dose around 100 mg daily (not hourly) and work up slowly. 500 mg every hour would probably be too much for a small child and may be quite uncomfortable though not necessarily unsafe. I wouldn’t attempt a high dose clean out without supervision from your naturopathic doctor.
My son is 9 months and 20 lbs. He eats tons of applesauce and drinks apple juice and he takes miralax. Should I take him off miralax and he takes magnesia. How much per day?
Hi Cathy, these are questions I can answer when I work with families one on one. Babies are built to poop, so being Miralax dependent at such a young age is something I would question with your doctor. He is likely also ready for more diversity in his solids too, besides apple sauce. Hold off on the apple juice – it isn’t nourishing for him at this age.
Please help my son. He’s 15 months old. He’s been constipated since he was 2 months old. We had him on Similac Advance first, then Similac Sensitive, the Similac Total Comfort. Nothing helped, so we just give him suppositories every few days so he can poop.
When he does poop, it’s hard and streaked with blood. He usually cries when he poops. It’s horrible. I feel so terrible for him and I don’t even know where to begin!!
He eats a good diet of fruits, veggies, grains, proteins, and milk. I tried switching him from milk to Soy milk (as that has the highest fat/calorie content) but it did nothing.
My mommy gut is telling me that he has a dairy protein allergy. I REALLY think that’s why he’s so constipated ALL THE TIME. That’s his only symptom-constipation.
Within the last few months, he has pooped with no help (no suppository) twice. Both times he bawled and both times they were streaked with blood.
Please give me any suggestions. What books do you have that will tell me what to do?
What books do you have that have recipes for high-fat, high-calorie, high-protein drinks for 1yos?
I will do anything to help my baby boy. Just PLEASE tell me what to do!!!
The only things he will drink are water and milk. He refuses to drink juice (too sweet I guess) but we still give him lots of “P” fruits which are supposed to help with constipation. Pears, plums, peaches, etc.
Please help my baby boy.
This sounds devastating and I’m wondering where your health care team is at on this? Has anyone guided you? No baby should go through this degree of discomfort. Start with suggestions in this blog. After that, your child may need a casein, soy and gluten free diet. These proteins can be constipating if they are not digested normally, regardless of whether or not they are allergenic. Soy milk will in this case be just as constipating as dairy source proteins like casein. If your child is also not gaining weight, this is a serious chronic condition that may need professional guidance to repair. Ask your doctor for a dietitian referral if your doctor does not know how to help you. I am happy to work with you one on one as well. Visit my site and facebook pages for updates on my weaning-off-miralax learning series for parents, which I hope to develop later this year.
What types of infant formulas are you referring to here:
“some infant formulas can trigger fungal overgrowth in a baby or child’s gut.”
Hi Katie, corn source maltodextrin and corn syrup are common carbohydrate sources in infant formulas. These readily feed dysbiotic flora like Candida.
I thought I already submitted this but can’t find it. My son started having issues with Constipation at 6 months when we introduced solids. For around 6 months we tried pear/prune juice with little help. Finally got referred to a pediatric Gastroenterology and he suggested switching from Cows milk to almond milk adding a probiotic and giving Miralax daily. Seemed to be working well my son is almost two and we have recently noticed major behavioral changes granted about a month ago we switch him back to cows milk to see if it was the issue. In December he was hospitalized and put through lumbar puncture to rule out meningitis, CT of brain for encephalitis and all they could come up with that maybe he had urinary reflux. However, after seeing a pediatric urologist he said they where fishing for an answer and that wasn’t what was causing my sons episode in the hospital. So still no answers. After doing some of my own research I was angry to find out that a lot of his symptoms are side affects of being on Miralax which they assured me was safe for him. He has also had several unexplained doctor visits where antibiotics where given. My question to you is how do I safely wean him off of Miralax or can I just quit cold turkey. Is there another option Magnesium I heard you mention in above post. Another probiotic that is better we have made the transition back to almond milk as he has had bad eczema for the first time in his life. Also what test should I request I recently had a scope myself and fungal was found in my esophagus could he also have this, or should I ask for stool sample. I want to get to the root of his constipation and stop having to add stuff that is only hurting him in the long run. I live in California would you be able to help!
I don’t recommend removing Miralax without first creating other tools to resolve constipation, so kids can comfortably wean off and keep stooling. The multiple antibiotics your son has had aren’t going to be adequately corrected with an over-the-counter probiotic, though that was a fine enough start. Also – it isn’t yet usual practice for a pedi GI to do a functional stool test. They generally just rule out a few egregious pathogens like Salmonella, Giardia, C diff, or Campylobacter. Lots of other disruptive stuff can be happening that those tests will miss. If you’d like guidance on lab tests and what to do, set up an appointment with me and we can dive in. I do work with families remotely. You should also be sure to sign up for my newsletter so you can get announcements on my upcoming webinars on topics like constipation and Mirlax. Sign up here (you’ll get my free Sensory Nutrition Checklist when you do).
My son started having constipation issues right after adding solids. Tried to address it with just pear/prune juice but it wasn’t helping. Finally after seeing a ped gastrointerologist he suggested mirilax that was when my son was 14months old he has been on it daily and he is almost two. I just recently noticed some mood swings, anger behavior changes and read up and was furious about them not telling me about the side affects of mirilax. However, I have always wanted to get to the root of the problem. He was delivered C-Section and has has several times where he was placed on an antibiotic. I do give him a probiotic daily too. My first question can I take him off Mirilax cold turkey or do I need to wean him off of it and also is there another substitute in the meantime that I should put him on until they find out why he has so much issues with constipation. I also read a post above about asking for fecal testing. I just received an upper and had fungus within my esphogus could he also have this. I am out of state but would love some guidance about steps to take with my pediatrician or to look elsewhere.
Got it – thanks for clarifying. This very early antibiotic exposure, even this brief, can disrupt the progression of normal gut flora colonization enough to injure feeding and growth, in my experience. PPI for 3 or 9 months in first year is also a very long time, as it’s during a critical window for a baby’s development of gut-immune interface. I have not seen probiotics alone repair this at least in my own practice. Your pediatrician doesn’t do stool studies, you’re right – they will generally refer to GI for this, and even at that they will only typically do cultures for egregious infections (which your kids very likely do not have, otherwise they’d be very sick) and not for fungal species. I don’t prescribe drugs as a dietitian/nutritionist so can’t use fluconazole, but I can say that yes when it is prescribed for kids I work with, it is often successful and well tolerated. If you’d like more support for how to repair feeding, use probiotics, and use herbal non-prescription supports to repair gut biome, set up a spot on my calendar anytime by clicking the Learn With Judy tab above and explore from there.
Sorry, I guess that was unclear. They were in the NICU for 4 months but were only on antibiotics twice for prophylactic use and discontinued after 3 days when cultures came back negative. Samuel was on PPI use for 9 months but the other two were only on it for 3 months. Though I imagine even that could affect guy biome. How long after initiating probiotics until you expect changes to occur? In the event the probiotics don’t help I was hoping to take them to a functional doctor if I can’t convince the our pediatrician to do the stool studies. Is flucinazole the antifungal you have the most success with?
The boys had some antibiotic exposure while in the nicu for 4 months but they were mostly prophylactic in nature, we only ended up treating twice in one of the boys. When the boys were 9 months old they stopped eating, they were put on feeding tubes and we went down the looooong road of determining if there was a milk allergy changing from breast milk to EVERY formula you can think of. The GIs solution was to give them time and they would start eating. Wrong, they actually stopped taking all food by mouth. We tried it all… (allimentum, nutamagen, puramino, etc). We also exhausted the reflux opinion and were on PPIs for about 3 months (Nothing changed their desire to eat). After doing extensive research on feeding tubes and the long term complications and recognizing my GI was not interested in solving the problem, I found a Behavorial therapist who specialized in children with feeding aversion, she assessed the boys and after ruling out medical possibilities she determined the likely root of the issue was feeding aversion (long story but there was a lot of pressure put on feeds). We then initiated the process of removing the tubes and were successful at getting them back to normal feeds. We removed every potential allergen when they were 9 months (we weren’t having any bowel issues at this point). I just started them on Garden of Life-Dr. Formulated Probiotics Organic Kids and calm gummies yesterday. I’ve not started lowering the miralax yet as I’ve not seen any change is stool consistency yet. How quickly do you usually see a change when these components are added?
I don’t see changes until the dysbiosis is fixed. The culprit in your boys’ case was long term PPI use + very early antibiotics. Four months on antibiotic at birth is a very long time and does not allow usual development of a healthy gut biome or gut-immune interface. Throw in possible poor tolerance of 9 month booster shots, especially if they got first dose MMR then. This is a perfect storm that skews gut biome toward fungal species and dysbiotic bacteria, due to the overly buffered pH caused by PPI and due to antibiotics favoring fungal species overgrowth. This leaves kids with no appetite because their stomachs are always buffered, which feels as though you’ve just eaten and are full. To fix all this, you have to aggressively fix the dysbiosis and this should be based on stool studies. Just some probiotic may not get the job done.
I have three-year (almost) old Identical triplets who suddenly started having constipation last March (yes, all 3 within a week of each other). They had some constipated bowel movements that were painful and then created withholding. Now it appears that there is anxiety associated with having a bowel movement. They started withholding and crying when ever the urge occurred. Our pediatrician stated that becoming aware of having a bowel movement often initiates withholding in children and therefore the constipation is likely due to the withholding and that it was very common with this age of children. She thought that softening the stool would allow the painful memory to subside and solve the problem. Upon our pediatricians advice, we initiated MiraLAX in order to soften the BM allowing for the painful memory to subside and allow them to go on their own. With the MiraLAX, their stools are soft and should be painless. However, they still try to withhold, allowing for only. soft small “nugget” BM and often cry at the thought of having a bowel movement though the BM should not be causing pain.. Since that time I have periodically tried to lower their dose in order to get them off of the MiraLAX unsuccessfully. This was supposed to be a short term solution however it has not been. The boys are on a healthy balanced diet, receiving a protein, fruit, grain, and vegetable with each meal. I have lowered the amount of milk they take from 24 ounces a day to 16 thinking that might be a reason for their constipation but there was no change. I should also mention that they are on a higher calorie diet which includes liqugen MCT oil in there milk. I can’t determine if the constipation is due to the withholding or something else? They were born at 26 weeks and a pound and a half each. They are developmentally and medically healthy with no lasting medical complications. They are however very small and only at 2 to 4% on the growth chart. Getting them to catch up has been challenging. I am a pharmacist and very familiar with MiraLAX, I also recognize that this should not be a long-term solution. My initial hope was that it would be very short term, as I’ve seen in many, but it has not been for us. In the last three years my confidence in the medical community has wained quite a bit and I experienced medical specialists who were not interested in solving the problem creating new ones and placing bandages on current ones. I was previously forced to look for alternative specialists and methods in order to deal with feeding aversion and NG tubes for the boys. I agree that mag oxide is a good choice, I wish I would’ve started there. I think will begin initiating the natural calm gummy’s at one 83 mg gummy a day titrating up based on results and lowering the miralax. My question for you is this, how familiar with you are you with this type of situation? Do you see this often and have you been successful in determining the root problem in cases like this?
I am very familiar with this scenario. I do often see this. I do often have success in resolving it and weaning off Miralax. FYI: If your boys don’t digest casein well (there are various ways to assess this), you would not see an improvement by reducing the amount they eat from 24 to 16 oz/day. It would need to be eliminated and replaced entirely with a different protein that does not require DPP-IV enzyme system in the gut to digest. They may also have to eliminate gluten, soy and pea as well, as those proteins are similar enough in structure as to require same enzyme process – so if kids constipated by casein continue eating gluten, soy and pea proteins (especially drinks like Ripple milk), then the constipation and anxiety will continue. The anxiety is likely related to microbiome shifts in gut with whatever caused the constipation for them all at once. This cause may include: Use of PPIs; antibiotics; new foods; poor vaccine tolerance (did they get some boosters 1-4 weeks prior to this onset?). If your boys are also on NG tubes, I do work with this scenario also and can help find a more digestible feed option.
My son is 4 1/2 and has had functional constipation and been withholding for about two years. We took him off of Miralax a few weeks ago. Even with daily use of Miralax, he was going 4-5 days without having a BM so it didn’t seem effective and we wanted to try more natural means to keep his stools soft enough to prevent him from withholding. We used Natural Calm to start a clean out after he hadn’t had a BM for seven days. His stools became very loose and diarrhea like and he started to develop a rash so we stopped. After going four days without a BM, we mixed two capsules of Mag 07 in some almond milk today and gave it to him and he’s been have small mushy BMs. The Mag 07 seems to be effective but we want to make sure we aren’t giving him too little or too much. His GI doctor hasn’t been very helpful as far as recommending anything other than Miralax. Do you know how much Mag 07 would be appropriate for him? Also, I’ve heard that it isn’t good for long term use. Is there a better form of magnesium he could take daily long term?
I like Mag07 as it is magnesium oxide, which is a more effective laxative than magnesium citrate, which is what Natural Calm is. It also comes as a pill or a powder. For a young child, I would not exceed 500 milligrams daily of any form of magnesium without professional supervision. I have had a handful of older (bigger) kids in my practice who could use up to 750 milligrams daily of magnesium but too much can be unsafe. Don’t follow the label instructions for Mag07 pills for a young child – this is too much magnesium for a four year old. Reduce the dose and only use the amount needed to trigger stool. Note your child may still have impacted fecal matter and this may need other means to clean out besides magnesium – if you’re still stuck, you can work with me anytime by getting into my calendar here (phone/Skype or in person).
Thank you! Since the day of your reply, I’ve been giving my son one. and a half capsules of Mag O7. However we just got back from the GI doctor and after looking an a xray, my son is severely backed up. She said we need to either start a clean out with 3 capfuls of Miralax for three days and then a capful daily for the next week or two until he’s cleaned out or he needs to be admitted into the hospital for a few days where they’ll do a Miralax cleanout as well. We’re really really want to avoid this but are unsure what dosage of mag O7 would be needed to safely begin a cleanout at home. I asked the GI doctor about using magnesium citrate to do a cleanout at the hospital or at home but she said it wouldn’t work or do enough to soften the blockage. Could you recommend anything that would be safe to get things moving and soften the blockage well?
Hi Bernice, I’m not able to advise on this further in this forum. If you’d like more help, best next step is to set up an appointment so I can provide appropriate oversight on using magnesium. BTW Mag 07 is ozonated magnesium oxide, not magnesium citrate – and it is thus a more potent laxative. It can work well for clean outs. If your doctor doesn’t know how to use it for this purpose then you do need professional oversight from someone who does, and I am happy to help. Bear in mind though, there may be other issues at hand that would trigger better results besides using a laxative (whichever one is chosen) alone.
Hi, how much Mag 07 would you recommend for my 5 year old? He is 30-40 lbs. I can weigh him if needed.
Hi Lisa, see my reply to Bernice – same question.
Hi My 3 year old son has been struggling with chronic constipation since he started more solids at about one year old. At 1 1/2 years old we started him on miralax with great success but we ceased usage when we noticed once a month he would get really sick and vomit and be very lethergic. The constipation got so bad we seeked professional help from many GI specialists who prescribed us with lactose which worker wonders until my 2 1/2 year refused to take it. After many further tests and consultations we were told to give miralax another chance. Which we did hesitantly for the past 4 months now and the vomiting has returned. I really would like to try the magnesium as an option as I do not want to continue using Miralax. Any advice or insight on this is greatly appreciated.
Hi Amina, if you’d like to work with me on solving the cause of constipation for your son, contact me here and my assistant can reach out to you to schedule care.
Our pediatrician prescribed a daily dose of miralax for 4-6 months as our son had chronic loose stools, often had accidents (at age 5), and pooped multiple times a day. He said he likely had encopresis. He has done great on the Miralax, but we are now at the 5th month point, and trying to ween and we are back to where we were at 5 months ago. Not sure if we should just continue with the Miralax inevitably or look into other options.
Hi Charlie, there are always other options! If Miralax is the one-trick-pony for your pediatrician, then you are always free to explore alternatives. If you’d like to know why your son’s gut was having this trouble in the first place, then working with me will mean we find out, and fix the problem. You can get started anytime by clicking here to set up a consult (in person or by phone/Skype).
Hello,
My son has been prescribed Miralax since he was 3, he is now almost 17 and still has no control and gets impacted every other week. We’ve gone to doctor after doctor who all blamed him for the problem and said he needed to stop being so stubborn and needs to just go. We finally found out that his intestines are so dependent on the Miralax and his intestines may have atrophy issues from not working properly for so many years. I’ve tried everything I can think of, even giving him spoon fulls of olive oil to teas to probiotics, diet, supplements, cleanses etc.
I don’t know what to do. It’s interfering with him being able to play sports, be social, go to school or even have a job.
Do you have any advice?
Hi Katie, I’m sorry to hear your son has been through this for most his life. I highly doubt this is his behavior or preference to live this way! There are several reasons why this may be happening that relate to what he eats, how it is digested, and what his gut biome does with it. These are not usually things that a GI doctor will investigate. It can fail to tinker with them (as you’ve so earnestly tried) without the baseline data first, on what his gut biome profile is, or what happens to proteins in his diet from wheat, milk, or other foods when he eats them. All of these can be manipulated and optimized so that his colon can work as intended. If it has been distended for a long time, it can be difficult to recover normal muscle tone, but it is worth investigating so he can have a normal life. If you’d like to go forward, set up an appointment with me here. I work remotely with parents via Skype or phone as well as in person.
Wake up America!
Thousands of children on Miralax now under psychiatric care!
In 2011 the FDA warned against POSSIBLE NEUROPSYCHIATRIC EVENTS-In ADULTS!
MIRALAX is NOT FDA APPROVED for use in children.
Bayer does not recommend anyone under age 17 take Miralax.
Hi Judy, What would be an appropriate dose of Mag 07 for a 60 lb 7 year old child? Adult dose is 3 pills, would 1 be ok for him? Thank you.
Hi Nicole, I can’t and don’t give individual dosage recommendations in this forum. I have no way to know if this measure is appropriate in your child’s case. For specific nutrition care support like this, it’s best to work with a licensed provider and you are welcome to make an appointment anytime – then I am able to assess your child’s nutrition needs and confidently make recommendations.
Hi, my son is 21 years old and has autism (so developmentally, he is much younger) He suffered with overflow diarrhea when he was much younger and then battled it off and on which impeded toilet training for bowel movements until he was 14. Once we developed a motivational bathroom chart, he became much more regular. However, for the last couple of years he goes through bouts of constipation. We have always used Miralax off and on since he was little. The last few weeks, I’ve been giving to him several times a week. Tonight, I heard him trying to go with extreme straining which then resulted in two small rock hard stools. He usually experiences HUGE normal consistency bowel movements which can and often do stop up the toilet. He takes a probiotic with L Rueteri and has taken that since he was around 5. We’ve also had him off and on various supplements. Thankfully, he takes pills without much fuss. I would like to stop the Miralax completely but often times it is the only thing that helps. But it only helps if I give it to him often. Based on your article above, I think maybe we should start him back on Vitamin C and Magnesium. Could you recommend a dosage? He is 6’1 and 180 lbs. Thank you for your time and assistance.
Hi Shelly, I can’t recommend individualized care plans or supplement dosing in this forum. If you are needing specific guidance for how your son can use magnesium and vitamin C, best option is to schedule an appointment.
My 14 year old daughter has battled constipation and encopresis since infancy. She has been on MiraLax for about 12 years now. She still supplements it with Dulcolax because the Miralax isn’t working! When we discuss this with her Ped GI, they get aggravated at me, saying things like “Well, IF she was taking her TWO ADULT doses every day like we said, it would be working. You must not be following our prescribed methods.” She just barely weighs over 100 lbs and has been on 34 grams of Miralax/day for almost 2 years now. I am DESPERATE to get her off Miralax, but nothing else we try works either. When I suggest additional testing to see if there is something else causing the constipation, I am told point blank that they do not do colonoscopies on anyone under 18. My 14 yr old daughter is even asking them to do one. I’m at my wits end. Are there any Ped GI dr’s in my area (Louisville, KY) that follow along with your medicine philosophy? I am so tired of my daughter hurting because of this. Thank you!
Most pediatric GI doctors would give the same advice, unless they are trained in functional medicine. You don’t need another GI doctor to tell you the same thing, and I don’t know the resources in your area. I’d suggest working tools for gut health instead, and there are many, but first some functional stool microbiology and nutrition assessment is needed on the triggers for this constipation. Mainstream pedi GI’s don’t do this, but some functional MDs do. I am happy to help you with this and work with kids often with constipation this severe. If you would like that help, set up an appointment and we can work via Skype or phone. You can also visit the Institute for Functional Medicine website and enter your zip code for a nearby MD, but these are likely to be more costly and less detailed in approach than the nutrition and gut health care I provide.
My 9 yr old son has been taking 1/2 top of miralax twice a day for the third day now. He had been in pain and throwing up for 1 1/2 weeks. It got to where he couldn’t keep anything down. He was, also, having diarrhea in the morning. I finally had them do an X-ray on his abdomen. It showed he had constipation. Being on miralax he has passed pebble sized ones and also long very mushy ones. My problem is, I have no idea when he will be cleaned out so I can stop the miralax. What advice do you have about when I could stop the meds?
This situation needs and deserves assessment and individualized care, which is what I offer for kids who work with me. Make an appointment and we can get started. As long as he is on Miralax, your doctors will hope for him to have mushy (abnormal) stool and in many cases this still builds up in the colon (as you saw on X ray) because it is hard to expel mush. The task is getting at the root cause of the constipation and diarrhea, which is what I work on with families to discover and redirect. There is no way to advise without those pieces up front. Restore normal bowel function and your son won’t likely need Miralax anymore, but continue to bandaid the symptoms with a medication and his symptoms will persist.
My daughter’s GI wants her to stay on lactulose for the next 12 months to keep her stool soft. They said this is necessary in order for her intestine to heal and shrink back down to appropriate size. She has had very large stool all her life which led to stretching out her intestine, and ultimately, resulted in constipation. You mentioned that it’s not good to keep stool mushy but how would you get the intestine to shrink back down to size?
My little one is 9 with constipation. She started with it at 4 months old while exclusively breastfed. We gave her an ounce of prune juice each day which helped until she entered toddlerhood. Then it was back and fourth with ok to constipated. For years it has been a fight. We have always limited or eliminated “binding” foods. We have tried probiotics and digestive enzymes, with no luck. 1/4 capful of Miralax is all that helped. She would have hugh BMs. Her GI also wants her off it, but has only suggested more fiber – which gives her diarrhea, regular sitting on the potty times, more water, and kegal exercises. We took her off miralax and nothing has helped. After a couple with with constant runs to the potty with no sucess we are on miralax again. I would like to try magnesium but am unsure which type would be the best and dosage.
It’s likely that there is more to this story than magnesium – if your daughter has been struggling with this for nine years, some investigating is in order. You can try magnesium if you like – but without knowing her weight, usual food intake, use of other meds or history, I don’t know if magnesium is appropriate in her case, in what form, and at what dose. That said, dosages for school aged children for magnesium citrate (there are other forms, but this is commonly used as a laxative) can typically be safely used in the 150-350 mg range. Higher doses can be used but I would not recommend it without supervision. Happy to help out more, contact me for an appointment if you would like.
I have always had constipation issues. I am 67 and using mirolax. Doctors have said I could use it all my life with no problems. I hate the way it makes my stools but I need something. If you know of any other option, for older people, I would love to know. I take a statin drug so lm leary of anything with grapefruit in it. Would appreciate any input. Thank you.
Good on you Carol, for seeking better! You can use magnesium citrate (also good for your heart health) and usual adult doses range from 150-600mg daily but this varies with individuals. This is available in many forms: Capsules, liquids, powders – at most any supermarket, pharmacy, or supplement shop. You can also try high dose vitamin C, also widely available in many formats. Effective dose for individuals vary here too. Usual strategy for adults is to try 500 mg and increase to 5000 mg if you like, in split doses. These are safe together if necessary. Of course what you are eating will play into this and it’s likely that this needs attention too, if your doctor gave you a statin. And by the way, statins have also been over prescribed (like Miralax and reflux medicines). Pick up this book to learn about the negative side of statins and how to achieve heart health and overall vitality without them: The Great Cholesterol Myth.
Determining the root case of the constipation is key as well. I realize that is not always possible. However, food sensitivities can sometimes be the trigger.
Thank you Judy. In corresponding with our pediatrician it sounds like she’s learly about ordering the lab tests so I’d like to schedule an appointment with you, after speaking with my husband about it to make sure he’s on board. Before scheduling through your website I’m wondering if there’s any way you can provide me with the insurance codes that would be used so I can check to see whether or not the cost will go towards our deductible and/or total out of pocket amounts (we are located in Utah and have Select Health coverage).
Nutrition care/dietitian service codes have not changed with the ICD-10 transition that happened last fall. Diagnosis codes did change. Your coverage, if any, will probably depend on both these. Dietitian services are usually denied unless a child has a severe enough finding that relates to nutrition, and this is only discernible through an assessment process. Service codes for nutrition may include S9479, S9470, 96869, 96868 – but again, these may only be applicable if your child’s nutrition diagnosis codes trigger coverage. I also accept health savings account cards if this is helpful, and can give coded statements when requested at the time of your care. Hope this helps.
Judy, I have read several of your posts and have now read most of your book, Special Needs Kids Go Pharm-Free. MY QUESTION IS WHAT TINCTURE DO YOU RECOMMEND FOR INFANT CONSTIPATION OR POOR DIGESTION? My little girl is almost 9 months old. Her pediatrician (who we switched to because she comes highly recommended) diagnosed her with severe silent reflux at 2 months old, however no testing has been done because the pediatrician has felt confident about the diagnosis and hasn’t felt like testing has been necessary. Reluctantly, we have had her on ranitidine since she was 2 months. We have tried several formulas and have settled with Nutramigen which she seems to handle the best. She has still had issues stooling, which I contribute to the zantac but when I’ve tried to wean her off it she has shown the same painful symptoms from early on. After getting an ear infection and being on antibiotics a couple months ago she got the worst diarrhea and the worst diaper rash I’ve ever seen. It must have been a fungal infection. Right after her antibiotics I put her on the Klaire Labs probiotics you recommend and I feel like they have made a great difference. She did unfortunately get another ear infection and sadly is on antibiotics again but this time around there is no diarrhea or rash. I want my baby to be well, I want her off Zantac, and I want her digestion to work properly. On top of her GI issues she has major developmental delays and she is now in the early intervention program. We have PT/OT lined up as well as an appt with a highly recommended pediatric GI specialist. I’ve asked our pediatrician if we can PLEASE order a comprehensive stool culture, an IgG test, and a swallow evaluation (recommended by the early intervention nurse as well as an MRI). I’m debating scheduling appts with you but want to wait till we see our pediatrician in a week. THANK YOU FOR YOUR BOOK, FOR SHARING YOUR INVALUABLE EXPERTISE AND FOR HELPING KIDS IN NEED!
Glad to hear some progress has been had with the probiotic, but you’re right – more direct intervention is needed. If you are lucky enough to have an independent, integrative pediatrician, it’s a good move to ask for those lab tests. Most pediatricians don’t use them for a variety of reasons – from political, to lack of awareness, to cost issues in their practices. If they aren’t forthcoming, the best way for me to advise is to work with you. I truly can’t presume to know what is best for your child without the opportunity to review your daughter’s history, labs, food intake, and signs/symptoms in detail.
My 10 month old son has been on miralax since he was 4 months. I am interested in trying the magnesium, but am concerned about giving him the right dose, and nervous about giving him too much. How can I determine the right dose?
This would depend on his weight and a few other factors, so check with your pediatrician. Typically safe to use up to 100 mg magnesium citrate daily in ordinary circumstances at this age and stage, but if constipation is fierce, more may be needed. Ask you doc to be sure.
MIRALAX INFORMATION IN MEDIA
http://www.today.com/video/today/56743393#56743393
January 2015: brief article about Miralax written by a lawyer:
http://myadvocates.com/blog/miralax-fears-finally-get-fda-attention
Facebook site October 2015
“Parents against Miralax” with almost 2000 members.
Many parents would like a letter of intent to sue submitted to expose issues with Miralax.
Miralax@yahoogroups on-line with over 2000 members.
Almost 10,000 adverse events reported to the FDA as of March 2015.
In 2009 the FDA held an oversight board meeting in response to increasing complaints.
The FDA took NO ACTION, but several concerns were highlighted:
“In 2009 the Drug Safety Oversight Board discussed reports of metabolic acidosis, metabolic acidosis with increased anion gap, and neuropsychiatric adverse events in children using polyethylene glycol (PEG) products. Metabolic acidosis is a disturbance in the body’s acid base balance and causes too much acid in the blood. In some situations, metabolic acidosis can be a mild, chronic condition; however, it may lead to shock or death in severe cases. Neuropsychiatric adverse events may include seizures, tremors, tics, headache, anxiety, lethargy, sedation, aggression, rages, obsessive-compulsive behaviors including repetitive chewing and sucking, paranoia and mood swings.”
In 2011 the FDA warned against “POSSIBLE NEUROPSYCHIATRIC EVENTS” from Miralax.
https://www.gutsense.org/gutsense/the-role-of-miralax-laxative-in-autism-dementia-alzheimer.html
Two New York Times articles have spotlighted Miralax and concerning issues with side effects:
http://mobile.nytimes.com/2015/01/06/science/scrutiny-for-a-childhood-remedy.html?_r=2&referrer=
http://www.nytimes.com/2012/05/26/us/miralax-a-popular-cure-but-never-approved-for-children.html?_r=0
Interview with Carol Chittenden with the EMPIRE STATE CONSUMER PROJECT discussing overwhelming reports against Miralax with minimal action being taken by the FDA.
50,500+ views on-line.
After two years a $325,000.00 grant from NIH in collaboration with the FDA awarded to study to investigate possible absorption issues. Several institutions applied for grant, but Children’s Hospital of Philadelphia, a few miles from Merck was awarded the grant. Considering 40-50% of FDA funds come from the pharmaceutical industry this raises ethical questions.
http://articles.mercola.com/sites/articles/archive/2015/01/21/miralax-laxatives.aspx
http://grantome.com/grant/NIH/R01-FD005312-01
http://m.startribune.com/science/287997201.html
http://www.peoplespharmacy.com/2015/01/08/is-popular-laxative-too-risky-for-kids/
In 2008 the FDA detected the two poisons di-ethylene glycol and ethylene glycol in all eight lots of Miralax tested, yet this was not disclosed to the public. Ethylene glycol poisoning and polyethylene glycol poisoning present with almost identical symptoms. This information was disclosed in grant award information released by the FDA.
Per article below: “Those tests were conducted in 2008, but the results were not disclosed. Jeff Ventura, an FDA spokesman, said batches were tested because “many of the reported adverse events were classic symptoms of ethylene glycol ingestion.”
http://www.empr.com/safety-of-adult-laxative-given-to-children-questioned-by-fda/article/391184/
I read this article with interest. My brother was severely constipated as a child. Don’t know if it harmed him, but he has multiple physical and mental ailments. However, what I was wondering, I’ve been taking Nexium for about 8-10 years. I’m 63. Do you think it’s harming me? I would love to get your newsletter if it includes adult information. Thank you. Nancy Cerreta.
Hi Nancy, using reflux medicines like Nexium (which are proton pump inhibitors) has been associated with increased fractures in elderly. I don’t think it is a healthy option, in my opinion, though I know nothing of your health situation. I do know that other data show that PPIs diminish digestion and impede absorption of B vitamins and minerals. Using Nexium for 8 years is a long time; these drugs were never intended or approved for this type of use, but it’s common! It won’t work to add vitamin supplements because you simply may not be able to absorb those nutrients, if your digestive function is too reduced. If I were you, I’d discuss a plan to get off this drug with your doctor.