Laxatives: Safe For 10-Year-Olds?

can a 10 year old take a laxative

Constipation is a common issue among children, with around 30-35% of children affected. It can be caused by infrequent bowel movements, hard stools, large stools, and painful bowel movements. While constipation can be distressing for both parents and children, laxatives can be a safe and effective solution.

Laxatives are medications that treat constipation by softening stools or stimulating bowel movements. They are generally safe for children and can be administered orally or rectally. However, it is important to closely follow dosage instructions and not to give more than one type of laxative at a time.

Before resorting to laxatives, it is recommended to make dietary and lifestyle changes, such as increasing water intake, consuming high-fibre foods, and optimising toilet posture and bathroom schedules for toddlers. If these changes do not help, healthcare professionals may suggest laxatives as a treatment option.

There are various types of laxatives available, including stool softeners, osmotic laxatives, lubricant laxatives, and stimulant laxatives. Each type works differently and has its own set of active ingredients. For instance, osmotic laxatives like MiraLAX increase water in the intestines to help pass hard stools, while stimulant laxatives stimulate rectal muscles to push the stool out.

It is important to monitor the frequency of laxative dosages to prevent children from becoming dependent on them. Additionally, parents should consult a healthcare professional before administering laxatives to ensure the most suitable option for their child.

Characteristics Values
Reason for taking laxatives Constipation
Laxative forms Oral (pills, powder), rectal (suppositories, enemas)
Types of laxatives Stool softeners, osmotic laxatives, lubricant laxatives, stimulant laxatives
Active ingredients Polyethylene glycol 3350 (Miralax), lactulose, magnesium hydroxide, glycerin, magnesium citrate, senna pod concentrate, psyllium husks, inulin, prune concentrate, organic fennel, polydextrose
Age suitability Depends on the type of laxative, but generally not recommended for children younger than 6 months
Dosage instructions Follow closely and do not give more than one type of laxative at a time
Side effects Diarrhea, rectal discomfort, behavioural changes, Electrolyte imbalance
Alternative treatments Lifestyle changes (e.g. diet, exercise), abdominal massage, natural laxatives (e.g. prunes, apples, pears)

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What are the signs of constipation in children?

Constipation is a common problem in children, and it can be worrying for parents. It is characterised by fewer than two or three bowel movements a week, and the passing of hard, dry, or lumpy stools. The number of bowel movements may vary for each child, but a change in what is normal for your child could indicate a problem.

  • They are having fewer bowel movements than normal.
  • They are passing hard and sometimes large stools.
  • They are experiencing pain or difficulty during bowel movements.
  • They are bleeding from their rectum or have blood in their stool.
  • They have a swollen abdomen or are experiencing bloating.
  • They are wetting themselves during the day or night.
  • They have traces of liquid or soft stool in their underwear.

If your child is constipated, they may try to avoid or delay having a bowel movement. They may do this by standing on their tiptoes and then rocking back on their heels, clenching their buttocks, or doing unusual, dance-like movements. They may also show signs of trying to hold their stool in, such as clenching their teeth, crossing their legs, or squeezing their buttocks together.

If your child is constipated, it is important to encourage them to make simple dietary changes, such as eating more fibre-rich fruits and vegetables and drinking more water. Physical activity can also help stimulate normal bowel function. If these changes do not help, a healthcare professional may recommend the use of laxatives or stool softeners. However, laxatives should only be used under the guidance of a healthcare professional.

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What are the causes of constipation in children?

Constipation is a common problem in children and can be caused by various factors. One of the most common causes is dietary, with insufficient intake of fibre-rich fruits and vegetables and not drinking enough fluids being key contributors. Children should consume 20 to 25 grams of fibre per day, and it is recommended to increase their intake of fruits, vegetables, beans, and whole grains. Additionally, children should be encouraged to drink plenty of fluids, with water being the best option.

Another cause of constipation in children is withholding, where a child ignores the urge to have a bowel movement. This may be due to fear of the toilet, not wanting to interrupt playtime, or embarrassment about using a public bathroom. Toilet training issues can also play a role, especially if it becomes a battle of wills between the child and caregiver.

Changes in routine, such as travel, starting a new school, or spending more time away from home, can also affect a child's bowel function and lead to constipation. Stress and anxiety have also been linked to constipation, as they can impact digestion.

Certain medications and dietary supplements, such as antacids containing aluminium and calcium, anticholinergics, anticonvulsants, and narcotic pain medicines, can also cause or worsen constipation in children.

In rare cases, constipation in children can indicate an underlying medical condition, such as Hirschsprung disease, spina bifida, metabolic or digestive system problems, or hormonal disorders like hypothyroidism.

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What are the best laxatives for children?

While laxatives are not recommended for children younger than six months, they can be safe and effective for children experiencing constipation. Constipation is common in children, affecting roughly 30-35% of them, and can be caused by infrequent bowel movements, hard stools, or certain dietary habits. Before turning to laxatives, it is recommended to try natural remedies such as abdominal massage, consuming more water, increasing fibre intake, and reducing dairy consumption. If these methods do not help, there are several types of laxatives that can be considered, preferably under the guidance of a healthcare professional.

Osmotic Laxatives

Osmotic laxatives draw water into the stool to help it move through the colon more quickly. Polyethylene glycol 3350 (found in Miralax and generic laxatives) is the most commonly used osmotic laxative and is considered a first-choice treatment for constipation in children over six months old. It is tasteless, well-tolerated by children, and typically takes 1-2 days to show results. However, there are concerns about the presence of ethylene glycol and diethylene glycol in PEG 3350 laxatives and their potential side effects, which are currently being investigated by the FDA. Lactulose is another option in this category, although it is less effective than Miralax.

Stool Softeners

Stool softeners increase the amount of water and fat in the stool, making it softer and easier to pass. Docusate (Colace) is an example of a stool softener and is not meant for daily, long-term use.

Stimulant Laxatives

Stimulant laxatives increase the movement of the intestines to promote bowel movements. Bisacodyl (Dulcolax) is a stimulant laxative that is generally well-tolerated and takes effect within 6-8 hours.

Lubricants

Lubricants help stool slide out more easily and can be given to a child by mouth or placed in the rectum. Mineral oil is the most commonly used lubricant and is typically used in children over three years old. It may take about 1-2 days to see the effects.

Rectal Therapies

Rectal therapies, such as suppositories and enemas, are placed in the rectum and produce results within minutes. They are not meant for regular or long-term use and may be uncomfortable for the child.

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What are the best natural laxatives for children?

Constipation is a common issue for children, and it can be distressing for both the child and their parents. While laxatives can be a solution, it is always best to try natural remedies first. Here are some of the best natural laxatives and strategies to help relieve constipation in children:

  • Increase fibre intake: Eating more fibre-rich foods can help soften stools and promote regular bowel movements. Aim for at least five servings of fruits and vegetables each day. Whole grains, beans, nuts, and seeds are also good sources of fibre.
  • Encourage water intake: Drinking plenty of water is crucial for preventing constipation and promoting regularity. Children over one year old should have about four to eight cups of water per day, depending on their age. Babies can have two to five ounces of water starting at six months.
  • Promote physical activity: Daily playtime and exercise can help stimulate the digestive system and prevent chronic constipation.
  • Establish a routine: Help your child establish a regular bathroom schedule. Encourage them to use the toilet at the same time each day, either before or after meals, so that toileting becomes a habit.
  • Try probiotics: Probiotics can be an inexpensive and low-risk way to improve your child's gut health. Look for well-researched brands and strains, and give them a try for at least four weeks to see if they help.
  • Improve sleep: Make sure your child gets enough sleep, as rest is essential for overall gut health and proper digestion.
  • Massage and poses: For children around five years old, gentle abdominal massages and poses like the "knee-to-chest" position can act as natural laxatives. Warm baths can also help relax their muscles and promote bowel movements.
  • Natural laxative foods: Incorporate fibre-rich, natural laxative foods into your child's diet. Prunes, apples, and pears contain sorbitol, a natural sugar alcohol that acts as a mild laxative. Kiwifruit is also an excellent natural stool softener.
  • Dairy products: Unless your child has a cow's milk protein allergy, dairy products like yoghurt and kefir with live cultures can support normal digestive health.
  • Whole grain cereals: Choose high-fibre whole wheat pasta, bread, and whole grain breakfast cereals. Check the labels for fibre content to ensure your child is getting enough.

While these natural remedies can be effective, it is always best to consult with your healthcare provider before making any significant changes to your child's diet or lifestyle. They can provide guidance and help you determine the best approach for your child's specific needs.

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What are the side effects of laxatives in children?

Laxatives are generally considered safe for children, but they can have side effects. The most common side effects include:

  • Excessive gassiness
  • Bloatedness
  • Crampy abdominal pains
  • Worsening constipation when not taken with enough water (this applies to bulking agents)
  • Diarrhea (osmotic laxatives)
  • Rectal discomfort (enemas or suppositories)

There have been concerns about potential behavioural changes in children who use osmotic laxatives like Miralax, but the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition reports that there is no evidence to support these claims. However, it is always recommended to consult a healthcare professional before giving your child a laxative, as they are not suitable for everyone.

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Frequently asked questions

Laxatives are generally safe for children when used as recommended and under the guidance of a healthcare professional. However, they should not be the first solution for constipation. It is important to first try lifestyle changes such as increasing fibre and fluid intake, as well as physical activity.

Common side effects of laxatives include worsening constipation if not taken with enough water, diarrhoea, and rectal discomfort. There have also been concerns about potential links between osmotic laxatives and behavioural changes in children, but these are currently unsubstantiated.

Natural laxatives include prunes, apples, and pears, which contain a sugar called sorbitol that draws water into the bowels and softens the stool.

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