My number one recommendation for helping to solve pooping problems is to quit using Miralax. This may seem counter-intuitive. Miralax is a laxative afterall! That should help, right? Miralax also comes highly recommended by many pediatricians (Side note: Don’t get confused by names, Miralax is sometimes referred to as PEG (polyethylene glycol 3350) or Movicol).
1) Miralax is a band-aid fix. Miralax does nothing to solve the underlying intestinal, dietary and/or psychological problems that are causing your child’s constipation or encopresis. At its best, Miralax is short-term fix for softening up hard poop. At its worst, Miralax can make encopresis symptoms much worse. If Miralax helps relieve occasional constipation in your child, I say, “Great! Go ahead and use it!” However, if you’ve been using Miralax for more than a month and your child is still soiling (meaning leaving poop streaks or crumbs in his/her panties) or still exhibiting holding patterns, then it is time to get off of the Miralax. See more about this in a blog entry by pediatrician Dr. Claudia M. Gold.
2) Miralax does not help get the poop out. Miralax draws water from the intestine into the poop. This changes the consistency of the poop to be more watery. So as you take Miralax, the poop becomes softer and softer. This may help if you have occasional constipation. However, it does not provide any intestinal stimulation that your child needs to push poop through the intestinal tract. The poop can still sit in the intestine and the child can still hold it in. Ex-lax, on the other hand, is helpful because it is an intestinal stimulant and actually helps move the poop along.
3) Miralax can INCREASE your child’s desire to hold the poop in. The main cause of encopresis is holding the poop in. For most children, it’s the holding patterns that we’re trying to help them overcome. When the child takes Miralax, it makes the poop more watery. The nervous system in the intestine works best when a solid hunk of poop presses against the intestinal wall and sends a signal to the brain. If the poop is watery, the nerves in the intestine may do not function properly. This can cause the child to hold even more. Also, if the child is seriously constipated, the watery poop created by the Miralax may leak out around larger poop blockages in the intestine. Not good!
Not gonna lie, Miralax is expensive.
4) Miralax has not been approved by the FDA for pediatric use. Miralax has also not been approved for long-term use, yet many child take it for months or years. (See New York Times article about this here). This alone should give you pause about giving to your child on a long-term basis.
The label says to use no more than 7 days! I know parents who have given Miralax to their children for YEARS! Don't do it.
5) The bottom line is this: Ask yourself, “Is Miralax helping my child heal?” Have you been dealing with pooping problems for more than a few weeks? Has your child been soiling in her panties for months? (My guess is that the answer to this question is “Yes!” since you are reading a pooping blog!). Miralax is not working. Any positive effect that you will see from Miralax will occur within the first 14 days. My pediatrician kept recommending Miralax for my daughter for 18 MONTHS before I woke up and realized that it was not working.
[Note: Quitting Miralax is a great first step, but you're probably going to have to make some other changes too.]
I’d love to hear from you. Have you given Miralax to your child? What was the result?