Natural Miralax or Laxative Alternatives
“Laxatives are merely but a bandaid when it comes to constipation. We need to focus our efforts on finding the root cause.”
Miralax is one of the most commonly prescribed medications for toddlers and children, even though it is not FDA approved for children under 17. It also is only intended to be used short-term (the label indicates no more than 7 days at a time), but I see many children in my practice that have been on it for YEARS! That being said, nearly all of my clients with chronic constipation come into my practice on Miralax, since this is the only solution their pediatrician and/or gastroenterologist gave them.
Are you ready for a shocking fact? Miralax actually does nothing to treat constipation. The active ingredient, polyethylene glycol, causes a rapid influx of water into the gastrointestinal tract, causing anything in the gut to be “flushed out”. This is called osmotic diarrhea (you’ll see that Miralax states on the label that it is an osmotic laxative). Having chronic osmotic diarrhea can lead to many other issues like dehydration, imbalance of electrolytes, dysbiosis, and damage to the lining of the gut. Think of Miralax as a bandaid - doing nothing to actually treat the root cause, but just masking symptoms of the actual issue. For example, let’s say that your child really has an underlying yeast overgrowth that is causing chronic GI issues and constipation, will a rapid flush of water/bowel movement do anything to treat this? No. Will changing diet and using supplements targeted to yeast help treat the overgrowth (the root cause), therefore helping the chronic constipation? You bet.
It is my goal to find out the root cause of your child’s constipation. Many common issues for constipation include:
Dehydration
Lack of fiber in the diet (nearly inevitable for kids with selective diets)
Food sensitivities
Yeast overgrowth
Imbalance of bacteria
Fungal infections
Physical inactivity
Overuse of laxatives
Lack of digestive enzymes
Low stomach acid
Underactive thyroid
Withholding a bowel movement (for behavioral reasons, or because they are scared of the pain associated with prior BMs)
Finding the Root Cause
Finding the root cause of constipation can sometimes be rather simple, and other times be somewhat complex. One of the best things we can do is trial multiple treatments and/or do multiple biomedical tests including, but not limited to:
GI-MAP Stool Testing, which includes testing for:
Bacterial, parasitic, and viral pathogens
Dysbiotic/overgrown bacteria
Yeast/fungi overgrowth
Parasites (protozoa & worms)
Antibiotic-resistant genes
Intestinal health markers for digestion and fat malabsorption
Gut inflammation
Markers for intestinal permeability (Leaky Gut Syndrome)
Mediator Release Testing (MRT) which includes:
Reactions to 170 different food items
Grains
Dairy
Fruits
Vegetables
Beans/Nuts/Legumes
Meats & Seafood
Flavor Enhancers
Chemicals (natural & synthetic)
Other miscellaneous foods
3 Natural Treatments
If we have done biomedical testing (food sensitivity testing or GI-Map), I have already given you some instructions to help decrease inflammation in the gut and associated constipation. This is the first step in helping your child’s GI issues! Here are some other tips to get off Miralax:
1. Try Magnesium
Natural Calm is a great place to start. They have an adult and children’s version. The Kid’s product is best for children under 6, and we can start the adult product for older children.
Start with ½ tsp and gradually increase ½ each day (up to 2 tsp) until you find a good level for your child
2. Start a probiotic
Dosage and variety of bacterial strains really matter! Use a probiotic containing at least 20 billion CFU and at least 5 different strains of bacteria. Some of the best strains being:
Lactobacillus acidophilus
Lactobacillus plantarum
Lactobacillus rhamnosus
Bifidobacterium lactis
Bifidobacterium longum
Great product: Ther-biotic Complete by Klaire Labs (they have it in a chewable too!)
3. Trial an herbal GI-Supplement
Many herbs can be naturally anti-bacterial and anti-fungal. Some of these herbs include:
Oregano
Thyme
Cumin
Berberine
Black walnut
Garlic
Grapefruit seed extract
Caprylic acid
Undecylenic acid
You can also use products that have a mix of herbs:
GI Microb-X by Designs 4 Health
GI-Fortify by Pure Encapsulations
CD-Herbal by Kirkman Labs
These supplements should be used with the guidance of a healthcare professional
3 Lifestyle Changes to Help Constipation
Increase water intake
Buy your child a water bottle and let them use it at school, sports practice, at home, etc. As a loose estimate, here are the general water recommendations for kids:
Children 1-3: at least 5 cups/day
Children 4-8: at least 7 cups/day
Males 9-13: at least 10 cups/day
Females 9-13: at least 9 cups/day
Males 14-18: at least 14 cups/day
Females 14-18: at least 10 cups/day
Increase fiber intake
Fiber is what helps our stools bulk up and be easy to pass. Fiber attracts water, which helps keep stools moist. It also has many other nutritional benefits like lowering cholesterol and preventing chronic disease (heart disease, diabetes, cancer, etc.) Most Americans only consume half of their daily recommendation of fiber. Your child can take a fiber supplement, though fiber from food is the ideal source. The most fiber from foods comes from fruits, vegetables, whole grains, beans, lentils, and legumes. As a loose estimate, here are the general fiber recommendations for kids:
Children 1-3: at least 19 grams/day
Children 4-8: at least 25 grams/day
Males 9-13: at least 31 grams/day
Females 9-13: at least 26 grams/day
Males 14-18: at least 38 grams/day
Females 14-18: at least 26 grams/day
Increase physical activity
The American Heart Association recommends that children ages 6 to 17 years of age get at least 60 minutes of moderate-to-vigorous-intensity aerobic each day.
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