Understanding Miralax: The parents’ guide on how to approach constipation

shutterstock_246461050Increase water intake and exercise, adopt and maintain a fiber-rich diet and avoid foods that bind you.

These are common ways to find relief from constipation. But sometimes a child needs more to keep the digestive “engines,” (or bowels) moving.

To ease the discomfort of chronic childhood constipation, pediatricians often prescribe an over-the-counter laxative called Miralax, the brand name for the generic drug polyethylene glycol 3350.

The odorless, tasteless powder is typically mixed with 8 ounces of water or other liquid-of-choice and prescribed to children for use once or twice daily. Common side effects include loose bowel movements and sometimes diarrhea, bloating or nausea. These side effects typically improve when dosing is adjusted.

Miralax under the microscope

However, Miralax has become a topic of discussion and scrutiny among pediatricians, parents and the media because it has not been FDA approved for use in children. Some parents worry about treating constipation because various websites have published misinformation about the side effects of medications to treat constipation.

According to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), an organization comprised of more than 1800 pediatric gastroenterologists nationwide, Miralax use appears to be free of serious side effects in most children.

Boston Children’s Athos Bousvaros, MD, MPH, associate chief of Boston Children’s Hospital Division of Gastroenterology, Hepatology and Nutrition, says Miralax is among the best-studied medications in childhood constipation, and studies suggest it is both safe and effective.

“Miralax has been very well studied, probably more closely than any other medication over the past 15 years,” he says.

He also notes that Miralax is one of many alternatives designed to treat childhood constipation.

If you have questions or concerns about Miralax or would like to discuss alternative methods to treat constipation, Bousvaros recommends talking with your pediatrician to determine the best treatment plan for your child.

Tips to manage childhood constipation

Diet: Introduce and maintain a diet high in fiber. High-fiber foods include whole grains, legumes (chickpeas, beans, humus), apples (with the skin), cherries, pears, prunes and strawberries, to name a few.

Like the liquids: Encourage your child to drink more fluids, especially water, and limit caffeinated drinks such as soda, coffee and tea.

Keep moving: Increasing exercise can also help with constipation. Exercise aids digestion by helping the normal movements the intestines make to push food forward as it is digested. People who do not move around much are often constipated.

Plan mealtimes. Do your best to serve your child’s meals on a regular schedule. Often, eating a meal will stimulate a bowel movement within 30 minutes to an hour. Serve breakfast early so your child does not have to rush off to school and miss the opportunity to have a bowel movement.

Make time: Have your child sit on the toilet at least twice a day for at least 10 minutes, preferably shortly after a meal.

Download “When is a tummy ache not just a tummy ache?”, a guide to managing constipation and other common gastrointestinal conditions.