Transitioning Your Child Off Miralax or Laxatives


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, 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)

Food Sensitivity Testing, 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:

  • These supplements should be used with the guidance of a healthcare professional

3 Lifestyle Changes to Help Constipation

  1. 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

  2. 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

  3. 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.

Want 1-on-1 guidance?

I am here to help! My goal is to find your child’s underlying issues and help transition to a more natural and sustainable way for your child to have normal bowel movements, decrease inflammation, expand their diet, and live the highest quality of life possible. I provide 1-on-1 consults across the nation. To learn about the services I offer, you can:

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