As part of the Simply Well Series, we review frequently asked questions. In this edition, I answer “What is your recommendation on how much MiraLAX to give a 2 year old?”, and everything else you want to know about childhood constipation.
If you are a parent, there is a pretty good chance that your child has struggled with bowel movement issues at one time or another.
In fact, the Journal of Pediatrics stated in a 2018 study that a whopping 18% of toddlers and 14% of children and teens suffer from constipation.
To avoid chronic constipation and other complications in the pediatric population, it is important for parents to understand the signs of constipation, how to prevent or treat it, when to seek medical advice, and over the counter medication options (such as a polyethylene glycol product, like MiraLAX) that can help ease the discomfort.
Symptoms: More than just Stomach Pain
We don’t always keep track of how often our kid goes to the bathroom, especially if you are raising older children. If I asked my ten year old “Did you poop today?”, he would simply roll his eyes at me.
However, since constipation is such a common problem it is important to know what to look for.
The American Academy of Pediatrics (AAP) explains that children with constipation often complain of abdominal pain, decreased appetite, and painful or hard stools. These symptoms may come in go, or last for a long time.
When left untreated, severe constipation can lead a fecal impaction. This is a hard stool lump that builds up in the lower bowel causing a blockage. Liquid or loose stools may leak around the impaction and into the child’s underwear.
Medical literature shows that parents consistently report a number of abnormal behavioral changes like irritability, aggression, temper tantrums, disrupted sleep patterns, and withdrawing from activities in children with constipation.
Why is my Kid Constipated?
Getting to the bottom of WHY a kid is having trouble with bowel movements is often a great way to stop it before it turns into a health problem.
Constipation can be caused by a variety of reasons:
- Certain medications
- Eating too much processed food or drinking too much milk
- Switching from breast milk to formula
- Stress or mental issues
- Lack of exercise or outdoor time
If you can determine the cause, it could be a simple fix; however, other measures are often needed to help children.
Home Remedies for Treating Constipation in Kids
As with any condition, it’s best to avoid using medication as a first option if possible.
Luckily, there are a lot of safe and easy options you can try to treat constipation in children of all ages.
You can try giving your child pear juice or prune juice – 4 ounces or less per day. Juice contains a sugar, called sorbitol, that isn’t digested well, so it stays in the stool and helps clean out the bowel.
Abdominal massage and Exercise
A gentle belly massage is great for infants and small children. Try massaging the abdomen and bicycling the legs.
Older children can benefit from added exercise.
Increase fiber and hydration
To build a diet rich in much fiber, get several servings of fruits and vegetables each day, along with drinking enough water.
Scheduled Potty Time
This worked great for my child. Have your child sit on the toilet for a few minutes every hour or two. We gave her a coloring book or a tablet, and rewarded her with a sticker chart. It may sound strange to reward your child for going to the bathroom, but it helps them understand that it is a positive experience.
My kids love to read this book in the bathroom:
Medication Usage in Constipation
Before giving your child a medication to treat constipation, it is always important to talk to your child’s pediatrician. Your child’s physician can help you weight versus benefit and understand what products are approved.
Probiotics keep the good bacteria in your child’s digestive track. This keeps things moving smoothly. I always recommend:
Suppositories and Enemas, such as Fleet – Children’s Enema, often provide quick relief by stimulating the intestinal muscles and softening the stool. These can be uncomfortable for children, so it is best to check in with the doctor before using.
MiraLAX is an over-the-counter medication that works to soften the stool by pulling water in it. MiraLAX is for children over 1 year old for chronic or acute constipation. We will talk about MiraLAX in depth now, but it is important to talk to your child’s provider before administering this.
Can I Give my Kid Miralax?
All laxatives work a little differently. MiraLAX, and similar generic products, are osmotic laxatives, which means they draws water into the intestine to soften stools. The active ingredient is a product called polyethylene glycol.
MiraLAX it is the most recommended laxative by pediatric gastroenterologists. It is a tasteless powder that you mix in with water or juice.
If you are considering using MiraLAX you are probably wondering how much miralax to give and the what is the safety of Miralax.
Some doctors dose more aggressively than others, so it is important to check with your child’s doctor, however, this is a common dosing schedule for Miralax.
To determine the right dose for your child, first get their accurate weight:
For children one year of age and older, the initial dose (for the first three days) is:
- If less than 15 lb: 1 teaspoon per day
- 15 to 22 lbs, 2 teaspoons per day
- More than 22 lbs, 1 capful or 3 1/2 teaspoonfuls per day
After the first three days, the dose decreases:
- Less than 15lbs, ½ teaspoon
- 15-22lbs, 1 teaspoon
- 22-33 lbs: 1 ½ teaspoon
- 33-44 lbs: 2 ½ teaspoon
- 44-55 lbs: 3 teaspoons
- More than 55 lbs: 3 ½ teaspoon or 1 CAPFUL
So, to answer the original question “how much MiraLAX to give 2 year old”: use the above dosing chart based on weight.
Your doctor may advise you to increase the dose further based on response, how constipated they are, or other factors. Sometimes MiraLAX is given multiple times a day and often recommended for long term use.
MiraLAX has a quite controversial history.
In 2012, Jeanie Ward helped author and direct a petition at the U.S. Food and Drug Administration asking for a warning label and an investigation into Miralax regarding possible side effects including neuropsychiatric problems. Studies were initiated to see if MiraLAX causes neurologic side effects.
As of April 2018, the FDA says the current labeling for PEG 3350 accurately conveys its risks, and no additional warnings about neuropsychiatric issues in children are needed at this time.
When to Call the Doctor
If your child suffers from chronic constipation, it’s time to call the the doctor when:
- Episodes of constipation last longer than three weeks
- Dietary changes or adding hydration has not helped.
- The child is unable to participate in normal activities because of constipation.
- The child soils his clothes.
- If there is blood in the stool
Final Thoughts on MiraLAX usage in Children
MiraLAX is a very commonly laxative for children, and often recommended by experts. I have used it with my children.
Constipation is a common issue that most parents face. Prior to trying medication interventions, try some lifestyle changes and home remedies.
If those don’t work, quickly reach out to your doctor before things get too messy (and I mean messy in a literal way). Good luck!