For many parents, constipation is a regular challenge for their children and it’s one of the common medical issues associated with autism. While this is not something we’ve dealt with too often, I understand the frustration and anguish as parents watch their kids writhe in pain because they simply cannot poop. To deal with this problem, many doctors are prescribing MiraLAX as a remedy and I have heard parents actually claim that they have used this treatment for a year or two on their child. This brings with it inherent risks and I’m sharing this article about the dangers of MiraLAX and what other options parents have. In fact, this story won’t go away!
Why MiraLAX is Under Fire
In January, 2015, The New York Times (NYT) reported on the validity of using laxatives as a childhood remedy. The article reports that “doctors have long recommended these laxatives for their convenience and on the grounds that very little PEG 3350 (the active chemical in MiraLAX) is absorbed in the intestines,” but at the time, the FDA claimed there was not enough data about the effect of this chemical in children.
The FDA last year reportedly investigated the prolonged use of MiraLAX on children and their site currently reads, “FDA decided that no action is necessary at this time based on available information” for PEG 3350. However, given the track record of the FDA, I would myself say, “Let me see the evidence.”
More Recent Trouble for MiraLAX
Since the 2015 report, you might have thought this all settled down. Not so!
UPDATE: October, 2017: Read this doctor’s editorial on why the science is lacking and we can’t be sure at this time if MiraLAX is safe for children.
UPDATE: FEB. 15, 2017: More evidence for the dangers of MiraLAX: “Parents Say Over-The Counter-Medication Sickening Kids”
A Group of Families Comes Forward
6ABC News reported this week that an over the counter medication is getting kids sick. “A group of families approached Action News with disturbing claims that children have developed neuro-psychiatric problems after taking MiraLAX.”
Parents have reported anger, rage, aggression, anxiety, paranoia, mood swings. In response, Children’s Hospital of Philadelphia (CHOP) just conducted $325,000 of one of the main ingredients of MiraLAX, PEG 3350. At that time the Food & Drug Administration (FDA) reportedly told Action News, “there was “insufficient data to demonstrate a link between PEG 3350 and serious neuropsychiatric issues in children” – citing only 167 adverse events reported to the FDA through 2012. Unfortunately, the reporters found a LOT more than that…5 times as many in the reports they searched.
UPDATE #2: FEB. 28, 2017: “More families speak out over MiraLAX side effects for kids“
After the initial report on 2/15, more families reached out to 6ABC News. “Lots of parents have reached out to us asking what to do, desperate for answers, because some say after their children were prescribed MiraLAX off label, the behavioral issues started – from depression to anger, anxiety and mood swings.” In fact, this garnered so much attention that the FDA responded. Please visit Action News to read the FDA’s full statement. Additionally, the report links to the CHOP study, which, at the time of this writing (3/3/17) has not yet begun enrolling children.
UPDATE #3: APR. 3, 2017: Parental concerns over MiraLAX laxative continue to spur closer review
FDA, CHOP and Doctor Feedback
The FDA is continuing their study. This article lists the details of the study, which is being conducted at the Children’s Hospital of Philadelphia. Meanwhile, outraged parents have formed a Facebook support group. This article is worth a read for some of the stunning comments made by William T. Gerson, MD:
“One needs to remember that, unfortunately, children can rarely have the sudden onset of disturbing symptoms,” Gerson said. “Given the common use of MiraLAX, chance association is likely to occur; that by no means is meant to infer that there are not rare complications or that the use of MiraLAX is appropriate in all situations. However, there are no data to support a change in practice at this time and alternative treatments are not necessarily safer.”
This Sounds Familiar…
This sounds an awful lot like the initial response to mitochondrial disease or PANDAS, “It doesn’t exist.” “The symptoms are not a sign of a health issue.”
It also sounds like tobacco science: “We’ll keep using what is not recommended (longterm use of MiraLAX, use of MiraLAX for children) until we conclusively have evidence beyond your stories, Mom.”
UPDATE #4: DEC. 19, 2017: Is MiraLAX causing behavioral problems in children?
In this latest article:
- Another mom shares her story.
- Bayer reiterates that the usage time on the label is 7 days; anyone prescribing it for longterm use is NOT them, but a physician.
- David Rosenberg, Chair of Psychiatry at WSU & Children’s Hospital of Michigan says that “often children with digestive issues also have psychiatric issues.” Instead of docs just prescribing away (opioids, anyone?), maybe they should get educated on the human microbiome and find out why these things are happening to kids. Relieving symptoms without knowing what’s going on does very little to help a body.
More Reports of Harm
The study came about in some part because of the reports the FDA has received complaining of seizures, tremors, tics, headache, anxiety, lethargy, sedation, aggression, rages, obsessive-compulsive behaviors including repetitive chewing and sucking, paranoia and mood swings. (Unfortunately, this page has been removed from the FDA website.) You can read more about parental concerns about the dangers of MiraLAX on this NYT article, “Drug for Adults is Popular as Children’s Remedy.”
This FDA study has been going on since 2014, and as of today (4/5/17), it’s not done yet because the study “has not yet yielded concrete results,” according to The Legal Examiner. This worries because some government groups (like the CDC) have used delay tactics to adjust studies that should have been straightforward to show the results they wanted.
In addition, MiraLAX was never approved by the FDA for use in children. The current studies that show no dangerous adverse affects have not been adjusted for children, so there is no way to know if it can be causing damage. Meanwhile, another news story surfaced in June, 2015. Law360.com reports that a Pennsylvania man who took MiraLAX for 4 years under a physician’s supervision sued Bayer for kidney damage, citing PEG 3350 as the cause.
The Dangers of MiraLAX & the Experts
What do the experts say about the dangers of MiraLAX?
We’re Over-Constipated as a Culture
Over at Parents.com, Steve J. Hodges, M.D., associate professor of pediatric urology at Wake Forest University School of Medicine in Winston-Salem, North Carolina who widely prescribed this laxative to his patients defended his position. What’s interesting about the article is the prevalence of constipation in the Western world – he calls it an epidemic – and the causes: too much processed foods, too-early potty training, kids “holding it in.” I feel like this doctor has left out way too many causes of constipation. Remember too, that in this article, Hodges is defending his prescribing and that it’s the FDA – hardly the most caring of organizations – that has put MiraLAX on the firing line. In fact, some doctor recommend parents to “develop an exit strategy” to get off of MiraLAX.
PEG 3350 is “Safe”
So what is in MiraLAX and other laxatives? PEG 3350 is short for Polyethylene Glycol 3350. Autism Speaks reports that the FDA found trace amounts of ethylene glycol and diethylene glycol when studying these laxatives while the FDA claims these are toxic only in large amounts. Note that both of these chemicals are in antifreeze, but I don’t know if the chemical composition may be different in MiraLAX. The problem for me with “trace amounts” is that we’re not sure what other products our kids are exposed to that also have trace amounts. In addition, while most doctors and experts agree that trace amounts of chemicals safely leave the body, kids with autism have difficultly methylating and detoxing their systems the way that people without autism do. That would make me very nervous, and it’s part of why I keep my daughter to only natural remedies and additive-free foods.
PEG 3350 May Be Habit Forming – MiraLAX Isn’t
So I found several articles that said ONE thing, and several that said the other. The question: is MiraLAX habit forming? One article I found linked to a PDF of the MiraLAX label, but it did not claim to be habit forming, however it did say to check with your doctor after 7 days if you have no relief. Seven days…and some people are taking it for years and years.. MedLinePlus claims that PEG 3350 “may be habit forming,”
I’ve seen so many back and forth arguments about the dangers of MiraLAX, including the argument that since a child’s colon is not doing its job, the question of overusing this laxative is moot. That, however, is circumvention of the real problem. Like so many over the counter drugs, MiraLAX is merely treating a symptom and not removing the cause of constipation.
What Causes Constipation in Kids with Autism?
Don’t forget that constipation is a sign that the body is not working properly. Like so many symptoms that are experienced by kids with autism, the trick is finding the cause and then healing it, an approach that has worked well for my children. Wouldn’t you rather fix what’s broken in your child’s system? TACA Now has an excellent “poop page” on their site. It explains that autistic kids may have loose stools that should be easy to release, but still suffer constipation. This is called “soft stool constipation.” It’s well worth a read.
However, Dr. Alessio Fassano, founder of the Center for Celiac Research and one of the leading experts on Celiac disease and leaky gut reported on a July 2014 study done at Seattle Children’s Hospital that showed a subgroup of individuals with autism and GI symptoms/constipation were a result of a gene mutation. Check out Dr. Fasano’s presentation about autism, the gut and the brain here:
Other Gut Issues
In addition, there is a high correlation with food allergies and sensitivities in autistic children. You should seriously consider gut issues at work if you haven’t already. Kids who are not high functioning or are nonverbal have trouble communicating their discomfort. They may not even be aware of it, if they’ve had the problem their entire lives.
Causes of Constipation
Some other issues that might cause chronic constipation as a result of gastrointestinal problems include:
- dairy allergy, gluten sensitivity and other similar issues
- reaction to certain medications that are regularly taken
- birth from C-section
- GMO food
- environmental toxins
Read more at Digestion & Inflammation on TreatAutism.ca.
“What Other Solution Do I Have?”
This may be a problem that your child has suffered with for a long time and possibly in conjunction with autism. In my opinion, you should be very careful with medications of any sort. This is especially true if you are taking one designed for temporary relief for an extended period of time.
I don’t write this article to judge anyone. My own daughter was diagnosed with autism at the age of 3. It took many years to understand the medical and biochemical consequences of autism on her body. Constipation is unhealthy and painful. I understand that need to give your child relief right now. However, as parents we need to take the long view. Detoxing is painful for a child but the rewards of good health are well worth it.
And maybe a temporary fix is necessary, but there are other options besides risking the dangers of MiraLAX. First, I’m going to recommend you check with your doctor. If your doctor is strictly adhering to a lifetime of MiraLAX and feels that no other health issues are in play for your autistic child, you may want to look into another doctor who understand the brain-gut connection particularly in kids with autism.
Alternate Solutions for Constipation
Meanwhile, here is a list of alternatives to MiraLAX:
1. Homeopathy for Detoxifying
Now, I’m not talking about using homeopathy as a temporary remedy or short term fix, but as an active program you engage for a loner period of time for curing basic issues. For us, homeopathy has been key to so many issues – and this certainly was a problem! This is a whole body treatment. I saw loose stools as a road block to potty training and, in fact, after this issue went away, we started our potty training journey. We have healed many of her issues with homeopathy. When she is constipated now, we know she is truly sick. If you are already using this sort of treatment, I recommend you mention loose stools to your practitioner.
2. Epsom Salt
Epsom salt is a detoxifying agent that’s readily available, affordable and easy to add to bath water, making it a fuss free solution. My husband uses Epsom salt to destress and finds it very useful. As part of a detox plan, Epsom salt can be very effective. However, remember that Epsom salt is actually magnesium sulfate – a supplement – and is absorbed through the skin. If you or your child has challenges with magnesium, you may want to avoid this or check in with your healthcare provider. Additionally, there is medicine grade Epsom salt, which can be too strong for your system. (I know someone who used this and believes it had a negative effect on his bowels as too strong a laxative.) Here is my affiliate link to my favorite brand:
3. Senna Tea
Senna is an herb that acts as a laxative, and is FDA approved for such use. WebMD states that it is “likely safe for most adults and children over the age of 2 when taken by mouth.” You should be careful if pregnant or if you have certain GI issues, electrolyte disturbances or potassium deficiency, are on certain medications, and like anything else, overuse can cause problems. (Read the detailed list of side effects and interactions.) Seems like a temporary measure, not unlike MiraLAX. Try Traditional Medicinals Organic Smooth Move Herbal Tea 2-pack 32 Count 1.13 OZ, one of my favorite brands, senna tea that is certified USDA Organic.
4. Fix The Gut
Very likely, your child is suffering from gut imbalance issues. In the past, I would just recommend probiotic or the GAPS diet. GAPS, however, can cause or worsen constipation since there is no fiber in the diet at the intro. You can also try a different diet or other food solutions as well as probiotics. Here are a few more tips on constipation and GAPS from “GAPSDiet.com.” My favorite GAPS cookbook can be found at my affiliate link, “The Heal Your Gut Cookbook: Nutrient-Dense Recipes for Intestinal Health Using the GAPS Diet”
Learn everything you need to know about GAPS in ‘Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia.’
5. More Solutions
I recommend you check out TACA Now’s poop page. It has a list of 28 suggestions for constipation. It’s interesting to note that MiraLAX is suggestion #26 and comes with a warning, unlike Milk of Magnesia and Ducolax suggestions. (Ducolax, however, is a stimulant laxative and can cause dizziness, diarrhea and nausea.) They even recommend specialists to visit if your child is having a long term issue. Finally, “Natural Alternatives to MiraLAX” provides even more choices for your family.
You can also test your child for candida growth/overgrowth and perform an Organic Acids Test (OAT) and an IGG Food Allergy Candida Test. You can also do those together. You can also do an elimination diet to see what is affecting your child, but a test is spot on. However, insurance coverage may be difficult. According to Great Plains, the OAT test is more likely to get coverage with the insurances they accept, but you can combo it with the candida test to help that.
7. Detox Your Family
A clean gut can be created by removing toxins from your food and home! Everything you put in and on your body matters. Detoxing your family help with gut issues. It may help improve a whole host of issues, from skin irritations to negative behaviors.
For a really great post on how to help your toddler, check out “Naturally Easing Constipation in Toddlers” by Kitchen Stewardship, one of my favorite healthy cooking blogs! (Here is her post on constipation cures for adults.)
That’s a lot of information to take in! Kids with constipation both relief and real solutions that gets at the heart of their gut issue. I hope these resources help you and convince you that a life on MiraLAX is not your only option.
Has your child had chronic constipation? Has he recovered? I’d love to hear from you! What tips can you share with my readers?
Disclaimer: I’m not a trained medical provider. You should always check with your healthcare provider when you are changing care for your child or considering treatments.