As a doctor, I understand how frustrating and heartbreaking it can be to see your child in pain due to constipation. While Miralax is often recommended, it may not be the best long-term solution because it doesn’t address the underlying causes. Let’s explore what might be causing your child’s constipation and what you can do about it.

What Could Be Causing Your Child’s Constipation?

1. Not Enough Water

• Children need 1 eight-ounce cup of water for each year of age (e.g., a 3-year-old needs 24 ounces per day). Children 8 years and older should be drinking 64 ounces per day.

2. Low Fiber Intake

• Inadequate fiber is a common cause of constipation. Combine this with a lack of water, and you have a recipe for trouble.
• Click HERE for diet tips and the best foods for constipation.
• Fiber supplements and prebiotics can help fill dietary gaps, especially since many kids won’t eat enough vegetables or fiber.

3. Food Intolerances

• Dairy is a common culprit. For some, eliminating dairy milk is enough, but others may need to cut out all dairy (cheese, yogurt, ice cream, etc.).
• Gluten can also cause constipation in some children.

4. Introduction of Foods in Infants

• Food introduction in infants commonly causes constipation. Their tiny immature digestive tracts are still learning what to do! Adding pureed fruits like pear and prune, as well as prebiotics and probiotics, can help.

5. Withholding and lack of routine

• Some children ignore the urge to use the bathroom or will withhold due to a history of pain, creating a cycle that worsens constipation.
• Encourage daily toilet time in a non-stressful way. Have you child sit on the toilet for 10 minutes at the same time each day. Offer rewards for attempts (not successes). Use distraction methods as needed- watch a video, read a book together.

6. Thyroid Disease

• If constipation is an issue, ask your child’s pediatrician to check TSH (thyroid-stimulating hormone) levels.

7. Gut Microbiome Issues and Dysbiosis

• Bacterial Imbalance (aka Dysbiosis): The gut bacteria have significant impact on the gut’s motility. An imbalance can cause constipation.
• Antibiotics: These can kill off beneficial gut bacteria and promote yeast overgrowth, often leading to constipation.
• Post-illness: A history of food poisoning or gastroenteritis can disrupt gut’s bacterial balance.
• Treatment: Probiotics and prebiotics can promote a healthier microbiome. Lactobacillus reuteri (DSM 17938), Lactobacillus casei rhamnosus (Lcr35), and Bifidobacterium breve are some of the most well-researched strains showing improvement in constipation. However, finding the right probiotic can be like trying on shoes—you need to find the best fit. Prebiotics such as FOS and GOS can be curative for many kids, but again, it’s not a one-size-fits-all solution. Sometimes, anti-microbial and anti-fungal herbs are needed to reduce levels of dysbiotic bacteria and yeast.

8. Mental and Emotional Stress

• Stress: Slowing down the pace of life, re-evaluating your child’s schedule, and creating a comforting routine can help when stress is contributing to constipation.
• Lack of Control: Kids do not get to control much in their lives but they can control eating, sleeping, and pooping. When you can, giving them control and a say in things can reduce resistance and improve cooperation.
• Changes in Routine: Kids can often become constipated when their routine changes. Watch and know your child to understand if this is a factor.

Addressing Constipation in Children

These are the main factors to consider when addressing your child’s constipation. It may take time to establish a healthy, stress-free bathroom routine, but it will be worth it when your child no longer relies on Miralax.

Remember: The factors contributing to constipation are different for each child. Consulting with a healthcare professional is always recommended to ensure your child receives the best care and guidance tailored to their needs and unique situation.

In Health,
Dr. Joanne Aponte

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.