Could a Commonly Prescribed Over the Counter Medicine Be Harming Your Children?

By Dr. Skylar KulbackiMiraLAX is a commonly prescribed over the counter (OTC) medication that is becoming more popular among pediatricians for the treatment of constipation in their young patients. A laxative intended for adults, MiraLAX is now being prescribed to children and infants as young as a few weeks old.The effectiveness and safety of MiraLAX and its active ingredient polyethylene glycol 3350 (PEG) has not been tested in children.

“Safety and effectiveness in pediatric patients has not been established.” [1]

Even though there have not been any studies to confirm the safety of the use of MiraLAX in the pediatric population, it does not stop many pediatricians from suggesting to parents to put their children on long term regimes using this potent drug. There have even been protocols created by The Seattle Children’s Hospital for long term use of MiraLAX, up to 12 months [2], even though it states directly on the label to not use the medication for longer than 7 days.

The cutout from the MraLAX product label [3].

 What is this dosage doing to our children? Is it necessary?How does MiraLAX work?• PEG, the active ingredient in MiraLAX, is an osmotic laxative. This means that it acts by stimulating the intestines to pull in water from the body, softening the stool and allowing for an easier bowel movement. By pulling this water from the body and into the intestines, the risk for becoming severely dehydrated and experiencing electrolyte disturbances is greatly increased.What does this mean for my child?• By treating the symptom and not the source of constipation, a child may be at risk for developing long term complications due to chronic constipation and/or laxative use.• The effects of prolonged and habitual use of MiraLAX is unknown, but due to its properties, this drug can at the very least cause dehydration, malnutrition, and Gastrointestinal dysfunction in a child.• The body becomes accustomed to the stimulation provided by the medication, and constipation is likely to persist in the absence of laxative use. This creates a physical dependency upon laxatives to create a bowel movement at all.How to help your child suffering with constipation:• If your child is currently being treated for constipation using MiraLAX or another laxative, speak to your pediatrician about weaning your child off these medications safely.• Try to figure out why your child may be suffering from constipation:o Is your child drinking enough water throughout the day?Kids Total Daily Beverage and Drinking Water Requirements:4 to 8 year old Girls and Boys need 5 cups a day9 to 13 year Girls need 7 cups a day9 to 13 year old Boys need 8 cups a day14 to 18 year old Girls need 8 cups a day14 to 18 year old Boys need 11 cups a day[4]o Is your child eating a diet consisting of naturally binding foods?BananasWhite bread/pasta/riceDairyo Does your child eat enough fiber each day?AvocadosPeasBlack beansNutso Does your child get enough physical activity throughout the day?Daily physical activity and exercised helps to keep the bowels healthy and regular.• If your child is still suffering from constipation after a change in diet, increased water consumption, and daily physical activity there are safe and effective options for promoting a healthy GI and regular bowel movements.o A daily probiotic will help to feed the GI and creates an environment for regularity.o Chiropractic care can remove any restrictions the body may have creating improper nervous system communication that directly regulate the bowel and GI tract.o A gentle belly massage using lavender oil can help to stimulate a bowel movement. Working from the child’s right lower belly and massaging little circles with your hands in a clockwise motion in an upside-down U will help to ease discomfort and encourage a bowel movement.Children should be having a bowel movement every day at the very least. For infants, it is more, at least 2-3 times each day. Feces are filled with toxins and it is vital to health that bowel movement are occurring daily. References1. Breckenridge Pharmaceutical Company. “Polyethylene Glycol,” Drugs.com, last revised Februaray 2016, [link].2. Seattle Children’s Hospital Research Foundation. “Constipation Treatment Recommendations When Child is Over One Year of Age, for New Diagnosis or Recurrence of Symptoms. [link]3. “Stop use and ask a doctor if you need to use a laxative for longer than 1 week,” MSD Consumer Care, Inc., “Directions,” “Warnings,” MiraLAX product label, [PDF file].4. Academy of Nutrition and Dietetics. “Water: How Much Do Kids Need?”, eatright.org, last revised May 2015, [link].