Chronic constipation is one of the many conditions on the rise among children. Unfortunately, it’s one that is too frequently treated by most pediatricians with over-the-counter medications, often MiraLAX, which comes in at #1 but ultimately may be harmful to our little ones.
As holistic primary care pediatricians, at GetzWell we know firsthand that there are better, safer ways to effectively combat constipation. In this post, we’ll explore constipation’s most common causes and the reasons for avoiding MiraLAX. We’ll also suggest methods for prevention and safe treatment of this common problem.
What constitutes constipation?
Kids should typically have 1-3 bowel movements per day and their stool should be formed and ideally look like types 3 and 4 on the Children’s Bristol Stool Chart, essentially a solid sausage or snake-like shape with a slightly cracked or smooth surface.
Infrequent bowel movements, especially fewer than 4 per week (or every other day), in addition to hard and difficult-to-pass poops are surefire signs of constipation and when left untreated, can be harmful to a developing body. We caution that before seeking a “quick fix” for your child’s constipation, you should first consult one of our holistic primary care pediatricians in order to investigate the root cause.
Underlying causes of chronic constipation.
Chronic constipation can be linked to the disruption of the microbiome – a community of trillions of bacteria, fungi, and microbes in the gut (a.k.a. gut bugs) that aid in digestion and intestinal motility.
To summarize, a newborn’s microbiome is ignited at birth when he or she is delivered through the birth canal and is coated with bacteria that nature intended for the new infant. Breastfeeding then continues the flora-fortifying process in 2 important ways: as a “probiotic,” or source of beneficial bacteria and as a “prebiotic,” moms’ milk contains unique oligosaccharides which exist nowhere else and act as a crucial food for healthy gut bacteria.
Today, more babies born via C-section (30 percent of all births in some hospitals) and paltry breastfeeding rates (formula use continues to increase) make for imbalances of gut bugs. This means that fewer kids end up with the healthy biomes needed for optimal intestinal function, hence important reasons for the uptick in chronic digestive issues such as constipation.
A child’s microbiome can also be disrupted for the long-term by the introduction of antibiotics in the first few years. The first 3 years are a crucial period when gut bugs are becoming established for a lifetime, and antimicrobials may cause irreparable damage because certain bacterial species may never fully recover after a course of an antibiotic.
A diet high in processed foods provides little nutrient density or fiber which can further deplete the gut’s microbial robustness and may mean a child ends up with an imbalance known as dysbiosis, contributing to slow intestinal transit.
Further, exposure to pesticides and pollutants in our food supply can impact a child’s intestinal health. The American Academy of Pediatrics in a 2011 policy statement called for protecting our children from the onslaught of chemicals entering our food supply and environment (to the tune of 250 pounds per person per day as most of these have not been proven safe for humans, let alone our developing children). This is the reason we recommend local, organic food as much as possible.
Other important factors contributing to constipation include consumption of too much dairy, not enough sleep, and inadequate physical activity. Additionally, it’s important to know that some children who experience the discomfort of passing a dry or large bowel movement may fear this happening again and begin to hold their poop in. This can become a vicious cycle as the longer they hold it in, the larger, dryer and more difficult it is to pass it. It’s critical to address the issue immediately so it doesn’t become a pattern.
So, why not resort to over-the-counter medications?
MiraLAX, an over-the-counter laxative, has become the go-to “remedy” for kids suffering from chronic constipation. What’s most alarming is despite its popularity among mainstream doctors there hasn’t been a comprehensive study on how it impacts children (or adults for that matter) and it has yet to be approved by the FDA for other than short-term use in adults. The label states, “For use in occasional constipation” yet we have seen kids who have taken it daily for years and can’t poop without it.
Thanks to recent studies conducted by the Children’s Hospital of Philadelphia (CHOP) we’re learning that there’s a risk of mood and behavioral effects ranging from depression, anger, anxiety, and mood swings after taking MiraLAX. CHOP researchers are looking into polyethylene glycol 3350 (PEG 3350), the active ingredient in MiraLAX, as the likely cause.
We still don’t know the full impact MiraLAX has on a child’s microbial, digestive and overall health, but we do know that it is not a solution to a deeper issue – one that we believe should be addressed rather than simply suppressing a symptom.
First preventing, then treating constipation — the natural way.
- Jerusalem Artichoke
- Pickles (fermented)
- Dark Chocolate
- Kefir (a fermented milk drink)
We also frequently recommend probiotic supplements to address and correct many tummy-related issues and irregularities. We carry pharmaceutical grade probiotics by Klaire Labs and BioGaia in our San Francisco offices.
We encourage trying easy-to-use prebiotic powders (which are “food” for the probiotics) including Sunfiber and inulin, which can be sprinkled on food, added to smoothies, or mixed in water.
Another pro tip: eliminate your child’s intake of dairy products for 2-3 weeks to see if this corrects the problem. In our clinical experience milk and other dairy products are the most common direct dietary contributors to constipation in kids.
Another great way to combat constipation is with magnesium, the wonder mineral. Ideally we would get our daily dose of magnesium directly from our food, but our food is only as magnesium rich as our soil. Unfortunately, our soil is direly depleted of magnesium due to over-farming. And to make matters worse, industrial pesticides like glyphosate, a “mineral chelator,” deplete plant minerals, yet another reason to purchase organic whenever possible.
Luckily, magnesium citrate provides an excellent way to alleviate constipation. It acts as an osmotic laxative, meaning it pulls water into the intestines to soften stool and encourage peristalsis. It can be purchased in powder form and mixed into a small amount of water or fresh juice. We like Natural Calm powder and recommend it frequently, not only for constipation but for relaxation and to support over 300 basic enzymatic processes in the body – we’ve seen it dramatically improve quality of life for kids and adults.
Additional natural alternatives.
Besides magnesium, one of our favorite “go-to’s” is Easy Going, a Chinese herbal remedy designed in San Francisco that works wonders – safely and naturally. We often recommend this for constipated kids in addition to magnesium and is available for purchase in both of our offices. Easy Going often hits the reset button, helping the intestine to remember its job is to move.
Aloe vera juice is another option that can be mixed into a small amount of juice or herbal tea. There are tasteless aloe brands like George’s that look and taste like water and are great for kids with the pickiest palates.
We do realize that some dire instances — such as the aforementioned “holding it in” situation, which can be quite dramatic and painful for a child – may require an enema or suppository. Please call the office for professional advice under those circumstances.
Address the physical and emotional roadblocks.
Get your kids outside and allow them to be as active as possible every day. Moving their bodies frequently encourages movement of their bowels. Create a reliable and relaxing bedtime routine they can look forward to, including bathing with Epsom salts.
Finally, take the stigma away from poop. Talk about it openly and in a matter of fact way. Let ‘em know that everyone does it and it’s nothing to be ashamed or fearful of.
Let GetzWell’s Gut Experts Help.
True to our mission at GetzWell, we don’t just mask symptoms. We want to ask “why” and get to the root of the condition. If your child is suffering from constipation, please we give us call at our San Francisco offices at 415.826.1701 – our holistic primary care pediatricians would love to help.