Treatment for Children’s Constipation without Miralax

Treatment for Children’s Constipation without Miralax

In January of this year the FDA announced it would fund research into the safety of the very popular constipation medication Miralax.

Though Miralax has been approved for use in adults and adolescents for less than 7 days, it has never been approved by the FDA for use in children.  Despite this Miralax has been a mainstay treatment by conventional pediatricians for use of constipation in children.

Polyethylene glycol 3350 (PEG 3350) is the active ingredient in Miralax.  Just so we are on the same page, ethylene glycol – or antifreeze – is not the same as polyethylene glycol.  Though polyethylene glycol is simply a string of ethylene oxide molecules, it is supposedly non-toxic and non absorbable, having no effect other than to loosen stool (poop).

So what’s the problem? The problem is that when the FDA tested batches of Miralax they found small amounts of actual antifreeze: ethylene glycol and diethylene glycol.  Not to mention that intestinal absorption of Miralax has never been studied in children, which is very concerning. The FDA has even received reports of psychiatric problems linked to the use of Miralax – specifically tics, tremors and obsessive-compulsive behavior.  This would suggest that at least some component of PEG 3350 is systemically absorbed, and we are not sure what the long term consequences are.

I’ve seen countless kids in my office with a chief complaint of chronic constipation, many of whom have seen conventional pediatricians and walked away with a prescription for Miralax.  I’m not blaming them – Miralax works extremely quickly and is an easy recommendation to make (we know it will work!) – but it also fails to truly address the underlying cause of why a child is constipated.

One of the main principles of naturopathic medicine is called “Tolle Causem” or Treat the Cause.  For kids to have permanent change in their bowel habits we first need to find out why they were constipated in the first place.  Read on!

First – how do we know they are constipated?  What “counts” as constipation?

Here’s a little guideline of what is normal for kids:

  • Babies 1 week old or less usually have 4 or more bowel movements (poops) each day.  They are usually liquidy or extremely soft.
  • Babies 3 months old or less can have bowel movements as often as several times per day, or as infrequent as once per week.  Breastfed babies tend to have less frequent poops because breastmilk is highly absorbable, which doesn’t leave much “left” to make a poop with.  If babies are very uncomfortable when passing stool (poop) then I still consider them to be constipated even though it is technically normal to go up to a week. (If it is bothering them, I think it is a problem!)
  • By age 2 most children have at least 1 bowel movement per day.  They should be easy to pass, formed, no blood in the stool, not pellet-like.   Though it is “normal” for kids to skip a day in between bowel movements, I aim for 1 per day.

If your child doesn’t meet the guidelines listed above, or is having painful stools or behavior changes around the time of defecation, then I would consider them to be constipated.   Rather than just give a laxative, let’s try to figure out why they are constipated.

Naturopathic treatment of constipation

Naturopathic treatment is always in the therapeutic order.  The first step of treating constipation is always addressing diet.  Many children are consuming shockingly low levels of fiber and fluid.  We recommend having your child consume half their weight in fluid ounces of water per day. (Weight in lbs.)  For example, a 20-lb child should consume 10 fluid oz of water per day.  

Secondly, consider addressing food sensitivities and allergies.  We have more information in our Constipation E-book.  Functional food sensitivities are quite common in children with constipation. 

Third, we recommend addressing peristalsis.  Peristalsis is the normal motion (movement) of the intestines.  It is what allows food to move in a snake-like fashion through the gastrointestinal system.  There are many great naturopathic therapeutics to help peristalsis!  Fermented foods are one great example.  Stress reduction and relaxation is incredibly important for normal peristalsis. 

Finally, consider having your child complete both a bowel cleanout, AND long-term laxative therapy.  There is a lot of misinformation in regards to long-term laxative use.  See this video on a naturopathic approach to laxative use!


We have SO Much more information in our Constipation e-book!

Erika Krumbeck, ND, FABNP
Erika Krumbeck

Dr. Erika Krumbeck is the proud founder and editor of, the leading internet source for trustworthy natural health information for children and naturopathic pediatric providers. She is also the owner of Montana Whole Health, a primary care naturopathic practice in Missoula, MT. She is one of few doctors with the FABNP designation, meaning she is a board-certified pediatric naturopathic physician. Dr. Krumbeck has specialized training in treating chronic conditions in children using safe, gentle and effective natural remedies. She helps bridge the gap between conventional medicine and complementary/alternative medicine by using both new research and traditional naturopathic therapies to guide treatment.


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    October 4, 2019 at 10:15 am
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    Angela Cameron
    August 18, 2017 at 8:38 am

    My son is 13 months old and had severe constipation. I tried prune but he was still having hard time pooping. Now he is getting Toddler magic tea with his formula and goes everyday without struggling.

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    Vicki Severn
    May 21, 2017 at 4:50 pm

    My great grandson has low muscle tone and has always been constipated. the only thing his Dr ever prescribed is miralax and he was on this until the articles came out about it My grand daughter took him off of it and has been trying prune juice and some herbs without much luck we have to use a suppository or enema to help him out his B.M.’s are the size of a grown man he only goes 1x a week the dr still says to use miralax it is so frustrating .he has a feeding tube

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      Maria Cristina Martino
      June 21, 2017 at 1:29 pm

      Hi Vicki, have you tried magnesium supplements? It is worth giving a try, plus you get a lot of ther benefits. Good luck 🙂

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    April 6, 2017 at 5:13 pm

    Hello my daughter has been on Myralx since November 2016 and the xray shows she still has stool compacted which the Dr. just said all test came back fine keep doing the Mrylax and we will see you in 3 months. To this I said NO, I wanted to know when this stool will pass and to get another xray to know is was gone and then to tell me what is causing this. My daughter has ADHD and is on meds for it along with counseling. Everytime her behavior gets worse so does her stomach issues. She also gets rotten egg burps. She was popping Zofran but also is pooping just not passing it all and it was so bad she was having explosive poop. They did tons of blood tests, we are on a dairy free diet completely. I am so frustrated. I want her better.

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      April 27, 2017 at 2:42 pm

      Your daughter and my son sound so much alike!! My son also has ADHD and is/was using miralax daily and only passing pure liquid but was always soiling in his underwear. Each abdominal X-ray would always show stool in his rectum and then we would have to do another clean out which just means increase the miralax to 8 times a day until the doctor was satisfied. I have taken him off the miralax in the last 2 weeks and am using culterelle for kids twice daily…. it has been amazing!! He is having formed soft bowel movements every other day and his soiling has decreased tremendously!! He also gets the feeling to poop which he hasn’t had in a year and a half!! Just wanted to share, maybe this will work for you!!

    • Avatar
      Maria Cristina Martino
      June 21, 2017 at 1:31 pm

      Try magnesium…

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    December 30, 2016 at 4:59 am

    Hi Anna. Is Probiota Sensitive suitable for a 3-year old? I need something for my daughter but am not sure whether to try Seeking Health’s infant or sensitive product. Than you!

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    Desirae Coopersmith
    December 13, 2016 at 6:10 pm

    My daughter has never had any bowel issues until now at 2yrs old which I’m sure is due to unhealthy eating. She is extremely picky and does not get at all close to the fibers she should be having. Instead of suggesting probiotics or more ways to get fibers for my daughter her doctor told us to start using Miralax which I do not agree with at all. For a child that has never had stomach issues why would our first resort be this. Please suggest food or a probotics if that helps bowels? I’m lost here.

  • Pingback: Constipation Remedies Children Miralax
    September 16, 2016 at 1:33 pm
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    August 30, 2016 at 2:18 am

    Which one of the Seeking Health products would you recommend for a child who just turned 6 and struggles with severe constipation since she was 2.5? Our pediatrician recommended Miralax, but then she loses the ability to go pee too and it adds to the problem so we didn’t bother with that. We do give her a very good diet so she does not get much junk. She does seem to have slow motility, and I’m guessing too much methane producing bacteria given that she’s often bloated and x-rays have shown gas building. She tested negative for Celiac or thyroid issues but did test positive intolerance dairy (severe) and moderate to high for gluten, chicken, and coconut so we eliminated all of those. She has mild intolerance to others like basil, bacon, etc. Every now and then she still struggles and so we’re thinking now she may have an imbalance of gut flora or SIBO or something and so we’re going to try a regular probiotic for her. Could you recommend a product from Seeking Health that we should get for her that’s appropriate for her age? Does it need to be shipped her refrigerated? I’m seeing negative reviews on Amazon for not probiotics not being shipped on ice? She often screams when she goes but then also says it doesn’t hurt…she’s always been a more emotionally intense child. She will go to the toilet fine on her own but really struggles a lot with being bloated and constipated. The dietary changes have helped – her hair started to grow out and she enjoyed running again and stopped W-sitting so we’ve seen big gross motor improvements by dropping the food intolerances completely out of her diet though she still struggles from time to time.

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    August 24, 2016 at 8:17 pm

    I have a 4 year old son who has struggled with constipation since he was an infant. He has been on Miralax consistently everyday for 2 years. It has been the only way he can poop. Lately Ive noticed that his bowels are very thin, ribbon like. I’ve backed off the miralax but not sure what do next to help him?

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    Lauren DiLisio
    August 7, 2016 at 3:49 pm

    My son struggles with constipation, and after reading this article I am fairly confident it is because we have unknowingly been feeding him too many constipation foods.
    In the article you mentioned an e-handout of a more comprehensive list of constipation and non constipation foods, but upon looking at your store I could not find this list. Could you please leave me a link to where to purchase this list?
    My son was prescribed miralax and after only a week we had to stop because it was giving him constant and painful stomach cramps.
    Thank you! This article was extremely helpful.

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    March 18, 2016 at 10:58 am

    Do you know of any probiotics that are good for toddlers and available in the uk? Thanks.

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    Anna Marney
    February 1, 2016 at 8:37 pm

    Hi Dr. Krumbeck, 

    Our 9 year old daughter has been using Miralax for 2 years now, as prescribed by her Dr as being safe enough for infants. I’ve only recently learned that this is not the case. I came across your excellent article while researching magnesium and probiotics in place of Miralax. I’m wondering if you could council me in my current plan of attack, to see if I’ve got it right.
    Can I discontinue the use of Miralax now, or do I need to ween her off?
    I found the Klein Kidd Ther-Biotics on Amazon, is that a good option for a purchaser? And do I start her on them one tablet per day, or do we need to work up to the full dose?
    I want to start her on magnesium as well, but have heard the magnesium citrate is not a safe option because of the citrate. I was going to order the Calm that you suggested, but do you know of another option that doesn’t have the citrate? She’s almost 90lbs, what dosing should I start her at? Also, do you have and opinion on magnesium spray oils or Epsom salt baths to help with increasing magnesium and decreasing constipation?
    And can Kiefer help with this as well? I’m trying to establish good gut flora and eliminate constipation, it seems as though they may go hand in hand.
    I really appreciate your very informing article, so much, in fact, that I planted myself in the health food section of our grocery store to read through the entire article, as I was searching for a probiotic. Anyhow, thank you. Reading this has given me hope and comfort that we can get our sweet Juliette’s tummy in good working order, naturally!

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        Anna Marney
        February 2, 2016 at 9:55 pm

        Gosh, thank you for that quick response! I didn’t have luck finding a naturopath Dr near us (sad face) and I’m not confident in taking her to her PCP for help in this area as that’s where the suggestion for Miralax came :/ I don’t know if this is one of thoes off limits questions you can’t answer, but I’ll ask in the hopes that you may be able to offer insight. Is Amazon a good source for ordering Kline Labs probiotics? And do you have a recommendation on a good one from them for adults (specifically me) to use as well? It seems their benefits are many. Or is it not recommended to take them on a regular basis?
        Again, so many thanks,

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    January 22, 2016 at 2:43 am

    You mentioned in this article some brands of pro-biotics you recommend and/or use. I am currently using Seeking Health Probiotic (Probiota Infant). Is that an effective brand?

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    December 9, 2015 at 4:24 am

    try home remedies for preventing it.

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    Suzanne Area
    July 23, 2015 at 8:44 pm

    My concern is a great grandchild…her constipation has become a family problem…I appreciated the information and suggestions
    and will alert my Granddaughter re: your findings and suggestions..Thanks you

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