As pediatric chiropractors, chronic constipation in infants and kids is one of the things we see most often in practice. If your child is one of the 30% of children that struggles with constipation you know that constipation often leads to frustration, irritability and general unhappiness in kids of any age. It is also likely that you’ve heard of Miralax, the common over-the-counter (OTC) laxative often recommended by pediatricians for kiddos experiencing constipation. Many parents are seeking drug-free options like Pediatric Chiropractic for issues like constipation especially after doing some research on the dangerous side effects of Miralax. 

What is Miralax?

Miralax is a common over-the-counter laxative. It was introduced in the early 2000s along with other laxatives with similar ingredients.

The main ingredient in Miralax, polyethylene glycol 3350 (PEG), is designed to help the digestive tract hold onto more water, which then pulls more water into the stool. This helps make the stool softer, making it easier to pass. Miralax often comes in powder form to be mixed with drinks like water, juice or milk before drinking and has dosage recommendations specific for adults. For anyone age 17 or older the label states Miralax should not be used for longer than 7 days.  According to the manufacturer’s site It is recommended to consult a doctor for use in children 16 and younger which means it may be recommended as off-label for this age group. Off-label means the drug is being used in a way that hasn’t been approved by the FDA. 

While pulling water into the stool sounds like a natural “softening” solution, the ingredient (polyethylene glycol 3350) and the mechanism it uses within the body certainly isn’t natural. This is where the discussion begins in terms of its usage and safety, especially when it comes to children.

Is Miralax a Safe Option for Kids?

Miralax has been a point of controversy for years after the FDA conducted a study in 2014 and found that 167 kids taking Miralax had severe emotional/psychiatric side effects. This debate has continued as the FDA has failed to approve its use for kids under the age of 17. Additionally, Miralax is primarily recommended for short-term use up to seven days to relieve constipation. Chronic use is not approved by the FDA, although many use it regularly or even daily to treat digestive issues. Its current use is considered off-label and while many pediatricians recommend its use for constipation many other sites and experts have documented common side effects that actually increase bloating, gas, cramping, diarrhea and even additional stomach pain and pressure. 

Additionally, the main ingredient’s (polyethylene glycol 3550) mechanism of retaining water works against the body’s natural process of nutrient and fluid absorption. While altering this process may provide temporary relief, long term working against absorption not only changes the biochemistry of the body, but also the brain’s communication to our digestive system.

This communication and coordination happens primarily through the function of something called the Vagus Nerve and Autonomic Nervous System, which has quite a bit of development to go through from birth through the first many years of life. When there is inference and dysfunction to this development, a condition called dysautonomia occurs and a common side effect of that is slowed digestive motility and constipation.

Developmentally, this learning of the digestive system naturally happens between 0-4 months while a newborn is laying the foundation with easy to digest breastmilk or formula. Then as baby grows, this simple process becomes more complex to be ready for solids at 6 months and more diverse foods going forward. 

Simply put, by following natural developmental milestones, the brain’s signals that begin working together, stay working together and are building blocks to the intricate balance of digestion (elimination) outward and absorption (of nutrients) inward.

What are the side effects of Miralax?

Every medication has its pros and cons, with solutions to issues, and of course, side effects. The most commonly documented side effects of Miralax are surprisingly the opposite of its intended benefit, leading to increased digestive struggles. Some Miralax side effects that kids experience include:

• Bloating

• Stomach cramping

• Gas

• Nausea

• Stomach pain or pressure

• Swelling in the stomach area

• Vomiting

• Diarrhea

Additionally, many parents groups have formed over the last 10+ years that are very critical of Miralax, citing experiences of their own children’s struggles on the medication and the documented studies which results have yet to show a definitive answer. These symptoms of Miralax include severe behavioral side effects such as anxiety, mood swings, anger, paranoia and massive personality changes. While there is still debate on the association of each side effect academically, see this article in Parents, the vast amount of parents, caregivers and clinicians coming forward with experiences cannot be ignored. 

As parents, you have every right to be angry and frustrated when you hear or see real life examples of the side-effects above. When you turn to medication, you want to be able to trust that it is not only effective but extremely safe.

Understandably so, many parents get quite angry when they get online and learn of all these behavioral and emotional side effects with Miralax for the first time. What we hope to do with this article is to help parents find a path and an option that gets to the root cause of their child’s constipation and then take action to care for it naturally and without drugs.

Drug-Free Alternatives to Miralax for Kids? 

From our clinical practice experience we find that kids struggling with constipation come from three main categories.

1. Nutritional & Food Intolerances

2. Neurological Interferences

3. Both Nutritional + Neurological

Here’s the wildest part of all this –  while nearly 100% of patients we begin care with have tried a multitude of diet changes, detoxes and supplements, etc. – almost none of them have been told about how important the nervous system is when it comes to gut and digestive health. 

The science behind it, especially as it relates to constipation and digestive issues, is super simple – an overstressed and overstimulated brain and nervous system is one that gets stuck in a perpetual, sustained fight-or-flight mode, known as the sympathetic side of the nervous system. When a child or person gets stuck in this state, it’s known as subluxation.

This sympathetic side of the nervous system is designed for protection and stressful situations, not for relaxation, sleep, ease and digestion. When stimulated, this “gas pedal” side of the autonomic nervous system works quickly to preserve resources for that “fight” or “flight” response, thus shutting down and limiting gut motility and function.

Limited motility and the wrong signals = constipation.

This lack of digestive motility caused by sustained sympathetic stress also limits the body’s ability to assimilate and excrete toxins and unwanted molecules. This is where the reactions to things like gluten, dairy and so forth come in, as well as an increase in behavior issues and emotional dysregulation. 

These foods are already more difficult to digest by nature, but if you have a subluxated nervous system filled with interference and distress…it struggles to digest and eliminate even the most basic of foods and healthy foods alike. 

This is where the ultimate frustration comes in for parents. You’ve thrown the book at this problem for your child with amazing nutrition and supplements, yet the problem persists. 

Getting to the Root Cause of Constipation

As parents you are no strangers to research and leaving no stone unturned! 2am google searches and even analyzing our kids “stool types” to get an idea of what your kid’s poop should actually look like are just some of the depths we will go to to find answers! 

If you feel like you’ve literally tried everything to help your child and still have not seen results, you could be like the thousands of parents who finally find that missing link once they learn about subluxation and dysautonomia and seek out neurologically-focused Pediatric Chiropractic Care!

If your child went through any of the following common prenatal and childhood challenges, then you absolutely will want to get them checked for subluxation and dysautonomia as soon as possible:

• Mental & Emotional Stress during the Pregnancy

• Birth Interventions such as Forceps, Vacuum Extraction, Manual Assistance, Induction, or C-Section Delivery

• Difficulty Latching, Nursing and Breastfeeding

• Colic, Reflux and Indigestion

• Ear Infections, Eczema and Skin Irritations

• Frequent Antibiotic and Steroid Medication Use

These are all things we find to be contributors to not just constipation, but also set the stage for chronic sensory and neurodevelopmental challenges as well. We refer to this sequence and accumulation of stress as the overall Perfect Storm. One stressor stacks on top of another and one diagnosis (colic) just gets a different name (sensory, spectrum, etc.) later on in life. 

It’s likely your doctor or someone told you that your child will “grow out of it” but the truth is, most kids “grow into” additional chronic health challenges if not properly cared for. 

Our Sprout Family Chiropractic docs know the neurology behind these challenges better than anyone else in health care and will not dismiss your child’s constipation and health challenges as “normal” and side idly hoping they grow out of it.

Experience a Drug-Free Future

If you’ve tried it all or are just getting started with helping your child’s chronic constipation, save the Miralax and drugs as an absolute last resort. The side effects of Miralax are many and can be long-lasting as well.

Since we find the vast majority of cases have that neurological stress and subluxation as a primary contributor, we strongly suggest scheduling a consultation and exam with a neurologically-focused chiropractor as soon as possible. If you are not in San Diego you can use the PX Docs Directory to find one near you. 

Our doctors are focused on addressing the root cause of your child’s health challenges and constipation. We are extremely thorough and detailed with our 3-Step Clinical Process and our INSiGHT Scans let us see what is going on with your child’s nervous system at a deeper level. 

We believe every child deserves a drug-free option as a first choice, saving all the side effects of things like Miralax as a last resort only!

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