When I work with families on sleep, I am always asking about poop! We all sleep better when poop is not too loose but not too hard either. MANY of the kids that I work with experience issues with their poop. Many children come to me taking Miralax every day. When that happens, I want to brainstorm together what we can do to support better poop and to brainstorm with your child’s doctor a) to figure out where the constipation might be coming from, and b) to find more natural ways to relieve constipation. Like many of my strategies, the goal is to use Miralax as much as necessary but as little as possible—to reduce Miralax if possible, but also making sure that we use it enough to sufficiently reduce constipation symptoms.
I am not a doctor, and I am not your child’s doctor. I am the Sleep Elf—an early childhood special educator with a background in sleep as well as transdisciplinary mental health and relationship tools. This information is provided as a tool for discussion with your medical team, and based on what I’m hearing from medical doctors referenced below.
Is Miralax safe for ongoing use in children?
“While we welcome the new investigation into safety concerns, I want to emphasize that any blanket rejection of using Miralax and other PEG-3350 laxatives might do more harm than good.
“I say this because unresolved and severe constipation can have serious consequences. These consequences include severe pain, intestinal blockages and blood loss from rectal bleeding. Years of chronic constipation can lead to loss of intestinal function to the point that part of the colon may need to be surgically removed. In short, untreated chronic constipation can lead to serious and even life-threatening conditions.
“As with any medication, we should weigh benefit and risk when placing someone on PEG laxatives. This is particularly true of young children.” (Q&A with GI-Autism Specialist Dr. Kent Williams)
Where might the constipation be coming from?
When we talk about constipation, one of the first questions I’m going to ask is when it started. Were there any changes happening in your child’s diet around the time that it started? (Is there any correlation with starting milk or a milk-based formula, for example?)
One of my favorite resources is the book Healthy Kids, Happy Kids by Dr. Elisa Song. According to Dr. Song, “The most common causes of acute constipation include dehydration, not enough fiber in the diet, and psychological stress” (Healthy Kids Happy Kids, part IV: integrative approach to the top 25 acute childhood concerns, constipation).
What are some ways can we reduce the amount of Miralax that we are using?
We can work with the doctor to try some strategies that loosen the stool, and when the stool gets a bit loose then we can talk to the doctor about decreasing the Miralax. Some strategies to consider in collaboration with your doctor include:
eliminating dairy
hydration
gradually increasing fiber
exercise
breathing for reducing stress
Belly massage (clockwise as you face your child)
Magnesium citrate (start small and increase)
Vitamin C
Probiotics for gut health
See Healthy Kids, Happy Kids by Dr. Elisa Song for details and more suggestions such as homeopathy, acupressure points, essential oils, etc.
If my child is on Miralax, what are some options for supporting iron intake and absorption?
Low iron can show up as difficulty falling asleep and staying asleep, restless sleep, and picky eating. Traditional iron supplements are going to be constipating and are not recommended for children who are taking Miralax. Another idea is to include organ meats or organ meat capsules into your child’s diet. If it is possible, you could try something like meat organ capsules (dissolved in some Jell-o jigglers if that’s helpful) or organ meats. Healthy Kids, Happy Kids has a list of foods that are high in iron.
AI disclaimer: This post was written by Lara Elfstrand, the Sleep Elf, a human being. AI was only used for certain titles and descriptions.
Medical disclaimer: My background is early childhood development, early childhood special education, postpartum doula and transdisciplinary mental health. I infuse infant parent mental health principles into my work, but I am not a health clinician or therapist, and I am also not a doctor. The services I provide are also not medical in nature and are not intended to diagnose, treat, cure, or prevent any disease.
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