Laxatives: A Child's Fever Risk?

can pedatric laxatives give a child fever

Pediatric laxatives are generally considered safe for children, but they can have side effects. Laxatives are used to treat constipation in children when lifestyle changes, such as increasing water and fibre intake, are not enough. While laxatives can be effective in treating constipation, they should not always be the first solution and should only be used under the guidance of a healthcare professional.

There are several types of laxatives, including stool softeners, osmotic laxatives, lubricant laxatives, and stimulant laxatives, and they can come in different forms such as chewable tablets, liquids, or suppositories. Common side effects of laxatives include worsening constipation, diarrhoea, and rectal discomfort.

While laxatives can be beneficial for children with constipation, they should not be used as a long-term solution. It is important to address the underlying causes of constipation and make lifestyle changes, such as dietary modifications and increasing physical activity, to improve bowel health.

Characteristics Values
Types of laxatives Oral, Rectal (suppositories and enemas)
How laxatives work Stool softeners, Osmotic laxatives, Lubricant laxatives, Stimulant laxatives
Side effects Worsening constipation, Diarrhea, Rectal discomfort
Safety Laxatives are relatively safe for children, but should be used with caution or avoided if the child has a history of electrolyte imbalance
Dosage Follow dosage instructions closely, do not give more than one type of laxative at a time
Frequency Monitor frequency of laxative dosages to prevent dependency
Alternative treatments Dietary changes (adding more water and fiber), prune juice, massage, acupuncture

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Are paediatric laxatives safe for children?

Paediatric laxatives are generally considered safe for children, but it is always best to check with a healthcare professional before administering them. Laxatives are used to treat constipation, which is common in children. They work by either softening the stool or stimulating a bowel movement.

There are several types of laxatives that can be used for children, including:

  • Polyethylene glycol 3350 (Miralax) is the first-choice treatment for constipation in children. It is tasteless, odourless, and mixes easily with other fluids.
  • Osmotic laxatives, such as lactulose, which draw water into the stool to help it move through the colon quicker.
  • Bulking agents, such as psyllium (Metamucil) or calcium polycarbophil (Fibercon), are fibre supplements that raise the amount of water absorbed in the stool, making it softer and easier to pass.
  • Stool softeners, such as docusate (Colace), increase the amount of water and fat in the stool, making it easier to pass.
  • Stimulant laxatives, such as bisacodyl (Dulcolax), increase the movement of the intestines to help the child pass a stool.
  • Lubricants, such as mineral oil, help stool slide out more easily.
  • Rectal therapies, including suppositories and enemas, are placed in the rectum and work well to remove stool but are not meant for regular or long-term use.

Laxatives are relatively safe to use in children, but each one has its own side effects. Common side effects include:

  • Excessive gassiness
  • Bloatedness
  • Crampy abdominal pains
  • Diarrhoea (with osmotic laxatives)
  • Rectal discomfort (with enemas or suppositories)

There have been concerns about the potential side effects of polyethylene glycol 3350 (PEG 3350) laxatives, which are the active ingredient in Miralax and other generic laxatives. The FDA has found very small amounts of ethylene glycol and diethylene glycol in some samples of these laxatives. While these compounds are generally considered safe at low levels, the FDA is investigating whether the amounts in PEG 3350 laxatives could cause significant side effects or harm to children. As such, it is important to work with a healthcare professional to determine the best treatment option for your child's needs.

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What are the side effects of paediatric laxatives?

Paediatric laxatives are generally safe and well-tolerated, but as with any medication, side effects can occur. The specific side effects will depend on the type of laxative and the individual child's response. Here are some of the possible side effects of paediatric laxatives:

Osmotic Laxatives:

  • Osmotic laxatives, such as polyethylene glycol (found in brands like MiraLAX and Dulcolax Balance), may cause nausea, bloating, abdominal cramps, and vomiting, especially when used in high doses.
  • Magnesium-based osmotic laxatives like Milk of Magnesia (magnesium hydroxide) or magnesium citrate can cause abdominal cramping due to increased serum magnesium levels.
  • Lactulose and sorbitol, which are synthetic sugars, can lead to bloating, borborygmi (rumbling noises in the intestine), and flatulence as they are fermented by the colonic flora.

Lubricating Agents:

Mineral oil (found in Kondremul) is generally well-tolerated but can cause perianal pruritus (itchiness around the anus) due to seepage into underwear.

Stimulant Laxatives:

Stimulant laxatives, such as senna (Ex-Lax, Senokot) and bisacodyl (Dulcolax, Bisco-Lax), can produce abdominal cramping, especially at higher doses.

Stool Softeners:

Stool softeners like docusate sodium (Colace, Docu-Soft) usually have fewer side effects but may cause mild gastrointestinal discomfort in some children.

It is important to note that laxatives should always be used under medical supervision, and parents should carefully follow the instructions provided by the child's doctor or healthcare provider. While rare, laxative abuse can occur, and long-term use without medical guidance can lead to dependency and other health issues. Additionally, some laxatives may interact with other medications, so it is crucial to consult a healthcare professional before administering any laxative to a child.

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What are the best natural laxatives for kids?

Constipation is a common issue for children, affecting roughly 30-35% of them. It can be caused by a variety of factors, including infrequent bowel movements, hard stools, large stools that are painful, or accidentally passing stools due to a build-up. It can be uncomfortable for the child and stressful for the parent. Luckily, there are many natural home remedies that can help.

Signs of Constipation in Kids

Children may show the following signs when they are constipated:

  • Two or fewer bowel movements per week
  • Hard stools (balls of stool or firm stools)
  • Painful bowel movements
  • Blood in the stool or when wiping (small fissure, or tear, of the rectum)
  • Firm or painful abdomen, especially after meals
  • Crying when going to the bathroom (common in babies)
  • A touch of blood left on the toilet paper or in the diaper
  • Fewer than normal trips to the bathroom
  • Recurrent UTIs in girls
  • Behaviour issues/meltdowns (especially in young children)
  • Nausea/feeling like they are going to vomit after eating

Natural Laxatives for Kids

  • Abdominal massage: For infants and small children, massaging the abdomen and bicycling the legs can help pass stools safely and comfortably.
  • Natural laxative foods: Prunes, apples, and pears are nature's laxatives. These fruits contain a sugar called "sorbitol," which draws water into the bowels and softens the stool. Other fruits that contain sorbitol include peaches, cherries, apricots, blackberries, dates, and broccoli.
  • Increase water intake: Water keeps the body hydrated, making it easier to pass stools. Babies can have 2-5 ounces of water a day starting at six months of age, while children should drink a number of 8 oz. glasses of water equal to their age (up to 8 years).
  • Increase fibre intake: Aim for five servings of fruits and vegetables each day, coupled with drinking plenty of water. Fibre-rich foods include whole grains, fruits (prunes, pears, kiwis, bananas, apples, oranges), vegetables, nuts, seeds, pulses, and other plant foods.
  • Decrease dairy: Excess dairy, especially milk, can cause constipation. Many children have a sensitivity to the proteins found in cow's milk. Other dairy products, like cheese, cottage cheese, or string cheese, can also cause constipation.
  • Probiotics: Probiotics can be used to keep the good bacteria in the stomach, especially while children are on antibiotics. Probiotics can also promote bowel regularity and improve gut health. However, there is limited research supporting their use to treat constipation, and they are not routinely used as a sole treatment.
  • Establish a routine: Help your child establish a regular bathroom schedule by encouraging them to use the toilet at the same time each day, either before or after meals, so toileting becomes part of their routine.
  • Physical activity: Encourage daily playtime as movement stimulates the digestive system and can help prevent chronic constipation.

Foods to Avoid

  • High-sugar, low-fibre snacks
  • Bran, as it can worsen constipation in some children

If natural remedies do not provide relief, consult your child's doctor, who may recommend medication, suppositories, or an enema.

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What are the different types of paediatric laxatives?

Paediatric laxatives can be classified into four broad categories. It is important to choose the right laxative for a child's specific needs, as not all laxatives are the same.

The first type is a bulking laxative, which is a non-absorbable complex carbohydrate that can hold on to water, maintaining a softer and larger stool that is easier to pass. Examples of products that contain processed husk from psyllium include Metamucil and Konsyl. Methylcellulose, a synthetic fibre, is the base for products such as Citrucel. Calcium Polycarbophil, a complex non-absorbable starch, is also a popular choice and can be administered in caplet form.

Lubricating agents, the second type, are based on mineral oil. Mineral oil does not get absorbed in the intestine and provides lubrication, preventing the stool from becoming compact and dry. A combination of fibre and mineral oil in emulsion form, such as Kondremul, is often preferred as it can be mixed with other fluids. Another popular stool softener in this category is docusate sodium, which includes Colace and Laxinate 100.

The third type is osmotic laxatives, which promote the accumulation of water in the intestinal tract, preventing the stool from drying out and enabling faster transit. Commonly used laxatives in this category include non-absorbable magnesium salts like milk of magnesia, magnesium citrate, and MiraLax, as well as similar generic products containing polyethylene glycol 3350 (PEG 3350). PEG 3350 is also the active ingredient in Miralax and other generic laxatives. However, the FDA has found small amounts of ethylene glycol and diethylene glycol in some samples of PEG 3350 laxatives, raising concerns about potential side effects with long-term use.

The final class of laxatives is stimulant agents, which include derivatives of the senna leaf (Senokot) and alkaloid chemicals such as bisacodyl (Correctol, Dulcolax). These work by directly signalling the muscles and nerves of the intestine to contract and expel its contents. While they work faster than bulking agents, they tend to produce more cramps.

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What are the signs of constipation in children?

Constipation is a common problem in children and usually isn't a cause for concern. However, if your child is experiencing constipation, there are several signs you can look out for.

Firstly, constipation in children is characterised by a decrease in the frequency of bowel movements, compared to their usual pattern. Generally, a child is considered constipated when they have fewer than three bowel movements a week, although this number may vary for each child. You may also notice that your child's stools are hard, dry, and difficult to pass. They may also be large, lumpy, or painful to pass.

Another sign of constipation is stool leakage, which may appear as traces of liquid or pasty stool in your child's underwear. This occurs when stool becomes backed up in the rectum. Your child may also experience abdominal bloating, cramps, or pain, and may exhibit signs of trying to hold their stool in, such as clenching their teeth, crossing their legs, or squeezing their buttocks together.

In addition to these physical signs, you may notice behavioural changes in your child, such as avoiding the toilet or changing positions to delay having a bowel movement. They may stand on their tiptoes and rock back on their heels, or perform unusual, dance-like movements.

If your child experiences constipation that lasts for more than two weeks, or if it is accompanied by rectal bleeding, blood in their stool, or constant abdominal pain, it is recommended that you consult a doctor.

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Frequently asked questions

There is no evidence to suggest that laxatives cause fever in children. However, laxatives can have side effects such as diarrhea, abdominal cramping, and rectal discomfort.

The side effects of laxatives depend on the type of laxative. Common side effects include diarrhea, abdominal cramping, and rectal discomfort. Osmotic laxatives may cause diarrhea if not taken with enough water, while stimulant laxatives may cause dehydration, flatulence, and cramping.

Pediatric laxatives are generally safe 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 dietary and lifestyle changes, such as increasing fiber and fluid intake, before resorting to laxatives.

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