Miralax - best dosage for 3-4 year old?

[TTC]

Hello -
I have posted before, with questions about constipation. My adopted DD, who is almost 4, has struggled with constipation since we adopted her at 10 months old- even before potty training. She is now mostly trained for pee, but we cannot get her trained for BM's. She seems scared to go. Granted, she had some incidents as a very young child where she had very painful BM's because of constipation. Once we realized what was happening, we got her onto mineral oil to help soften the BM's. However, once we tried to start potty training, we realized it was going to continue to be a problem. Some times, she'd go for 7-8 days w/o a BM. Enemas don't seem to work w/ her. Two different pediatricians recommended Miralax - which is an adult product but one said to give 1/4 cap or 1/2 cap to get her going and prevent her from being able to hold it, and the other said to go ahead and give a full cap. We have tried in recent weeks giving about 1/4 cap a day when she's gone 7-8 days but it seems to take 3-4 days to kick in. And then her BM's are very soft and messy to clean up. I am wondering if perhaps it isn't better to just hit her body hard w/ the full cap of Miralax and try to get it to all come out at once, rather than slowly giving 1/4 cap each day which seems to not be that effective for the first few days and then suddenly it starts working but then she'll have 4-5 accidents (or more) in a day and it's so soft that she can't seem to get to the bathroom on time and it has to be frustrating for her to have her body going that many times in one day.

For anyone who has had their child on this product in the past (or currently), do you know anything about the mechanism through which this works, or what the ideal dosage is?

Thanks!

[DawnL]

My ds just turned 2, and he has always been constipated, too. He has had Miralax prescribed for him, but I only used it when things were a "problem" for him. Well, I brought the Miralax to the Dr for his 2 year old check up. His pediatrician recommended that we give him a half capful each day, to keep things running smoothly. We're still working on the smoothly part, as he seems to hold it up for a few days, then go messy. (which is easier in a diaper, as I'm sure you can attest to!)

I don't know exactly what the mechanics of the meds are. I'm thinking that if you give it every day, it stabalizes, and it should be easier for them. But if you are at all uncertain, does your Dr's office have a nurses' hotline? If I have the slightest doubt about anything, I call them.

I would consider calling the nurse with your concerns. Maybe see if the nurse, or the nurse might ask the Dr, if there is something that works, but maybe isn't over effective, like the Miralax seems to be.

[flicka7]

My dd is 22 mo and we started her on Miralax at about 15 months. My pedi said to use it with Benefiber. We were doing 1/4 cap at breakfast and 1 Tbsp of Benefiber at lunch. She would only go every other day and it would be about 3 times in one day. My pedi bumped her up to 1/2 cap every day with the Benifiber too. Now she usually goes every day after lunch but it is very soft. Not runny, but it's a bit messy. She's still in diapers, so it's not a problem for me. I was hoping she'd grow out of it.

Do you give her bananas, applesauce, other binding foods?

[MarieL]

Marielle was on Miralax the whole time she was on chemo, because the chemo exits the body through the feces and they don't want it backing up in the child's system. (She also had constipation problems pre-leukemia but we would just add prune juice to her milk and she'd be fine. Once she started chemo, she didn't like the taste of it.)

Anyway, on treatment she got 1 cap full a day. Now that she is done with treatment, we give her 1 cap full every other day. Marielle was 3 at diagnosis.

I would suggest not waiting until she backs up. Try 1/4 to a 1/2 cap every day or every other day. As you can see, a child can stay on it for a long time. Why not prevent the back ups?

[4-boys]

My oldest was on Miralax for almost 4 years. If I remember correctly I gave him a big dose to start with to get things moving, then backed down the dose for everday. It got to where I just dusted the bottom of a sippy cup. That small amount kept him regular.

[CarrieW]

I just recently started my 20 month old on Miralax. I give her 1/2 teaspoon every morning. She weighs about 22#. Giving her a big dose won't really help more. My ped said all it does is draws water into the colon to make the poop softer. That is why it is okay to give continuously. DD has been on it for about 2 months straight and as long as she gets it everyday she stays pretty regular. She still doesn't go every day, but she also doesn't scream when she does go.

[NJ-DawnCuba]

My ds is 4 and we give him a teaspoon everyday and keeps him regular, he goes once a day right before bedtime, without missing a day. We love it.
While potty training and before taking this medication BM's were like living in hell.

When his GI specialist recommended Miralax, we started with a table spoon twice a day, which sort of adds a lot of liquid to his waste and puts him in mild diarrhea, then about 3 days after initial diarrhea we worked on getting a dosage that would help him go daily and this is where we arrived at 1 teaspoon a day, also we give it to him when he comes home from school and is very thirsty to make sure he drinks it all.

[Misty]

Two of my kids are on Miralex and the ped Rx'd 2 Tbsp per day. We put it in their milk at bed time. It works great!

[hopie]

MY 5 year old takes 1/2 a capful. The pharmacist marked it on the dosage cup, plus t he GI doc gave me a cap where he marked it as well.

[Louisette]

DS (now 4.5) has been on it since 3 due to hold in BM's. We started with 1/2 capful for the first 2 days which cleaned him out and then daily he gets 1/4 capful n his morning juice and thankfully, goes daily in the PM.

Good luck!