Wednesday, April 23, 2014
Hello, My 3 year old son has had a constipation problem. I believe it started when we started giving him regular food at around 8 months. We have tried giving more fluids, eliminating dairy, used high fiber breads and nothing is working. Our doctor has him on 2 tblspoons of benefiber a day with 1 teaspoon of miralax. Hes still no going number 2 after 2 days of this and I can tell he`s really hurting. Can you recommend anything?
There are several causes of constipation including thyroid disease, Hirschsprung's disease and what is termed functional constipation. The onset of symptoms at 8 months suggests that the child has functional constipation and this is usually treated with bulking and medications like miralax. Generally, it difficult to increase the bulk of a child's diet at age 8 months without using medications like benefiber.
The use of miralax is common in pediatrics now and is entirely safe is it is not absorbed and it is non-habit forming. The dose is titrated to the one that is needed to produce soft easy to pass stools once or more times/day. It is not uncommon for children to require a capful or more/day to produce this effect and the singular side effect of miralax is diarrhea. The dose should be increased to one needed to produce the soft stool consistency needed for easy passage. After attaining this goal, the duration of therapy is individual and after a few months the dose can be reduced to see if the child can be weaned off.
James E Heubi, MD
Professor and Associate Chair of Pediatrics
College of Medicine
University of Cincinnati