It might seem like when you’re not dealing with your child’s diarrhea or vomiting, you’re trying to get them to poop. Your little one’s digestive system is still learning how to run smoothly. Plus, as you may very well know, constipation can be a lifelong balancing act.

Up to 30 percent of children have constipation. It can happen to babies, toddlers, and older children. Your child might be constipated once in a while, or go several months without many normal bowel movements.

Of course, you’ll do anything to see your child healthy and happy. Fortunately, laxatives and other remedies can help, and over-the-counter (OTC) laxatives like Miralax do work. However, recent reports show that they might cause side effects in some children.

Here’s what to know about Miralax and whether you’re better off trying a more natural method to help with your child’s constipation.

Miralax is an OTC laxative that you can find at your local pharmacy or drug store. You don’t need a prescription for it. It typically comes in a powder form that you mix with water, juice, or milk. The Food and Drug Administration (FDA) approves Miralax for use in adults only.

The key ingredient in Miralax is polyethylene glycol 3350, or PEG. This chemical helps the digestive tract absorb water. The water softens and plumps up poop, making it easier to go number two. Polyethylene glycol might also help you have bowel movements more often.

Polyethylene glycol is very new on the constipation scene compared with other medications and remedies. It has only been used since 2000. This ingredient is also in other OTC laxatives like Glyvolax and Restoralax.

Many pediatricians say it’s OK to give your child Miralax. The manufacturer’s site advises that it’s “for adults and children 17 years of age and older” and says to consult a doctor for children 16 and younger.

According to the site, the recommended daily dosage — if you’re 17 years or older — is 17 grams of Miralax powder dissolved in 4 to 8 ounces of a cold or warm beverage (like water, juice, or milk). The bottle comes with a convenient measuring cap. It also states that Miralax should not be used for longer than 7 days.

Individual clinic and physician dosage recommendations for children vary quite a bit. The dosages you may find online can seem confusing, as they’re sometimes higher than what the manufacturer recommends for adults! It’s crucial that you consult your child’s physician, who knows your child’s medical needs best.

Although you don’t need a prescription for Miralax, it’s still a medicine. Its main ingredient is polyethylene glycol (PEG). Using too much Miralax can cause the opposite effects of constipation: runny poop and diarrhea. If you want to try Miralax, ask your pediatrician for the best dose for your child.

According to the label, it typically works within 24 to 72 hours. This is a long time to wait, especially when your little one is uncomfortable, but don’t give your child more than what your pediatrician recommends.

In theory, you can be allergic to PEG. However, in reality, this is extremely rare. A single case study reported an anaphylaxis (severe allergic) reaction, but only seven such cases have been reported worldwide since 1990.

Symptoms of a severe allergic reaction include:

  • itching
  • rash
  • swelling
  • tingling in the arms or other areas
  • dizziness
  • difficulty breathing
  • difficulty swallowing
  • shock

It’s worth mentioning that the Miralax manufacturer’s site has an allergy alert.

Miralax can cause some abdominal side effects, including:

  • feeling full or bloated
  • feeling stomach pain or pressure
  • swelling in the stomach area
  • nausea or vomiting
  • diarrhea

The Miralax label only mentions abdominal side effects — none other.

When it first came on the market, it was clinically tested to be safe for children. A few years later, parents and the media started reporting behavioral side effects in children.

However, there are no reports of this in the medical literature. One review is sometimes inaccurately cited. In the review, the following symptoms were reported while children were taking PEG:

  • anxiety
  • mood swings
  • anger
  • aggression
  • abnormal behavior
  • paranoia

That said, there’s no evidence that PEG caused these symptoms. In fact, the researchers reached the conclusion that “negative public perception triggered by media reporting and amplified by internet activity has resulted in” more adverse event complaints, as well more refusals on the part of parents to give their children PEG.

More medical research is needed to find out if polyethylene glycol is responsible, or if these behavior changes are linked to other causes.

Your child’s eating and potty habits might be causing their constipation. Some children are “potty-shy” because they either don’t want to sit on the toilet or they’re afraid that it will hurt. Your child may hold in their bowel movements — on purpose or not.

Avoiding or delaying going to the bathroom can lead to constipation in kids. Fussy eating habits can also change bathroom habits. If your child is eating lots of processed foods or not getting enough fiber from fruits and vegetables, they may have a more difficult time passing stools.

Not drinking enough water may also cause or worsen constipation. Eating or drinking too little also means your child will have to go to the bathroom less.

Let your pediatrician know if your child has constipation often. Health issues in kids can sometimes lead to difficult bowel movements. These include:

  • anxiety
  • stress
  • underactive thyroid
  • digestive disease
  • changes in the size or shape of the intestines and anus
  • spinal cord problems
  • nerve problems
  • muscle disease
  • some medications

There are plenty of good remedies for this age-old problem. If you ask your parents how they treated your constipation when you were young, you’ll probably hear some of these remedies. Give your child plenty of fiber-rich foods to help improve bowel movements:

  • prunes
  • citrus fruits
  • apples
  • pears
  • kiwifruit
  • figs
  • spinach
  • rhubarb
  • oatmeal
  • beans
  • lentils

Other home remedies for constipation include:

  • giving your child plenty of water to drink
  • using a stool to prop up your child’s feet when they’re sitting on the toilet
  • encouraging your child to spend more time sitting on the toilet

Occasional constipation is common in children (and adults!). It’s usually not cause for concern and doesn’t require medication.

See your pediatrician if your child frequently has difficulty going to the bathroom. When constipation is chronic, sometimes a health problem may be the cause.

A wide range of child health specialists recommends Miralax for chronic constipation — or for a “clean-out” for severe constipation. But this doesn’t mean that it will suit every child. More research is needed on the safety of polyethylene glycol’s use in children.

Your pediatrician may recommend Miralax or other laxatives. Ask for a natural alternative if you would like to try something else. Most doctors are happy to discuss these options. Regardless of what you choose, let your doctor know if you see any changes in your child’s health and behavior.