Laxatives: Safe For Kids?

Constipation is a common issue for children, but it can be a cause for concern for parents. While it's usually not serious, chronic constipation can affect a child's quality of life and lead to complications if left untreated. Laxatives can be a solution, but are they safe for kids?

Magnesium citrate is a saline laxative that can be used to treat constipation. It works by increasing the amount of water the intestines absorb, softening the stool and making it easier to pass. While this medication can be prescribed for children as young as two, precautions do apply. It is important to consult with a healthcare professional before giving any laxatives to children, as they can have side effects and may not be suitable for everyone.

Magnesium citrate is a saline laxative that treats occasional constipation

Magnesium citrate is an osmotic laxative, which means it works by drawing water into the intestine to soften the stool and make it easier to pass. It also increases pressure, prompting the muscles in the intestines to move the stool. This medicine may be prescribed for children as young as two years old for selected conditions, but precautions do apply. It is important to consult a doctor before giving magnesium citrate to children under five years old, as they may recommend a better treatment option.

Magnesium citrate is relatively gentle and usually results in a bowel movement within 30 minutes to six hours. It is available as an oral solution or tablet, but the oral solution is typically recommended for treating constipation. The dosage varies based on age, with people aged 12 years and older able to take up to 10 ounces of the oral solution daily, and children aged 6 to 11 years able to take up to 7 ounces. It is important to follow the directions on the package or prescription label and drink a full glass of water after taking this medication to prevent side effects such as dehydration.

While magnesium citrate can be effective in treating occasional constipation, it may cause some side effects, including diarrhoea, stomach cramps, high magnesium levels, and changes in other electrolytes in the blood. It may also interact with certain medications, such as antibiotics and drugs that lower calcium concentration in the urine. Therefore, it is important to consult a healthcare professional before taking magnesium citrate to ensure it is safe and does not interfere with any other substances.

Laxatives are available in oral and rectal forms

Laxatives are a group of medicines used to treat constipation. They can be taken orally as liquids, tablets, capsules, or powders dissolved in water, or they can be administered via the rectum in the form of suppositories or enemas.

Oral Laxatives

Oral laxatives are typically taken as liquids, tablets, capsules, or powders that are dissolved in water. They work by increasing the amount of fluid in the large bowel, drawing water into the intestines, and softening the stool, making it easier to pass. Oral laxatives usually take effect within 6 to 12 hours, although some may work within 30 minutes. It is important to drink plenty of fluids when taking oral laxatives to avoid dehydration and potential blockage in the gut.

Rectal Laxatives

Rectal laxatives, on the other hand, are administered through the back passage (rectum) and include suppositories and enemas. Suppositories are pellet-shaped laxatives inserted into the rectum via the anus. Enemas are liquids inserted into the rectum and lower part of the gut, also via the anus. Rectal laxatives usually work much faster than oral laxatives, providing relief within 15 to 30 minutes.

Types of Laxatives

Laxatives can be broadly categorized into four groups based on their mechanism of action:

• Bulk-forming laxatives: These increase the bulk of the stool by absorbing water, similar to how fibre works. Examples include ispaghula (psyllium) husk, methylcellulose, and unprocessed bran.
• Osmotic laxatives: These increase the amount of fluid in the large bowel by drawing water into it. Examples include lactulose, macrogols (polyethylene glycol), and sodium citrate enemas.
• Stimulant laxatives: These stimulate the nerves and muscles in the large bowel to push the stool out. Examples include bisacodyl, glycerol, senna, and sodium picosulfate.
• Faecal softeners: These work by wetting and softening the faeces. Examples include arachis (peanut) oil enemas and liquid paraffin.

Osmotic laxatives increase water in the intestines, making hard stool pass easier

Osmotic laxatives are medications used to treat or prevent constipation by increasing the amount of water in the intestines, making hard stools easier to pass. They work by drawing water into the colon, softening the stool, and promoting bowel movements. This is especially helpful for people who don't consume enough water and those with infrequent and hard-to-pass stools, which are characteristic of constipation.

Osmotic laxatives are available in various forms, including oral solutions, powders, and tablets, and can be purchased over the counter or by prescription. Some common osmotic laxatives include polyethylene glycol (PEG), lactulose, sorbitol, magnesium citrate, and magnesium hydroxide.

Magnesium citrate, for example, is a saline laxative that increases the amount of water the intestine absorbs, softening the stool and making it easier to pass. It also increases pressure, prompting the muscles in the intestines to move the stool.

While osmotic laxatives can be effective, they can also cause side effects such as nausea, bloating, cramping, flatulence, and diarrhea. Overuse of these laxatives can lead to dehydration and the loss of important electrolytes. Therefore, it is important to follow dosing instructions carefully and only use a laxative when needed.

Laxatives are generally safe for kids but should be used under the guidance of a healthcare professional

Laxatives are a group of medications that treat constipation, making it easier to pass stools. They are available in oral and rectal forms. Oral laxatives can be pills or powders that are mixed with water, while rectal laxatives are in the form of suppositories and enemas.

There are four main types of laxatives:

• Stool softeners: These add moisture to the stool, making it softer and easier to pass.
• Osmotic laxatives: Osmotic laxatives increase the water content in the intestines, aiding the passage of hard stools.
• Lubricant laxatives: This type of laxative coats the stool, making it slippery and easier to pass.
• Stimulant laxatives: Stimulant laxatives stimulate the rectal muscles to help push the stool out.

While laxatives are generally safe for children, they should be used under the guidance of a healthcare professional. It is important to follow the dosage instructions and not give more than one type of laxative at a time. Additionally, the frequency of laxative dosages should be monitored to prevent the child from becoming dependent on them for bowel movements.

Magnesium citrate is an example of an osmotic laxative that can be used to treat occasional constipation. It is available as an oral solution or tablet and can be purchased over the counter without a prescription. However, it is important to consult a doctor before giving magnesium citrate to children under five years of age.

To prevent constipation in children, it is recommended to encourage healthy habits such as regular exercise, a nutritious diet rich in fiber, and drinking plenty of fluids, especially water. Creating a bathroom routine and rewarding children for their efforts can also help.

Preventing constipation: build healthy habits, create a bathroom routine, and prioritise fibre and water in your child's diet

Constipation is a common problem in children, but it usually isn't a cause for concern. It can be prevented and treated with some simple measures.

Build Healthy Habits

Encourage your child to be physically active. Physical activity helps stimulate the bowels, so getting plenty of exercise can help prevent constipation. This can be as simple as walking, playing catch, riding bikes, or shooting hoops.

Create a Bathroom Routine

Developing a regular meal schedule can help children develop routine bowel habits, as eating is a natural stimulant for the bowels. If needed, schedule an early breakfast to give your child a relaxed opportunity to visit the bathroom before school.

If your child resists the urge to go to the bathroom, encourage them to sit on the toilet for at least 10 minutes at the same time every day, ideally after a meal.

Prioritise Fibre and Water in Your Child's Diet

A diet lacking in water and fibre can lead to constipation. Fibre-rich foods include fruits, vegetables, whole grains, and beans.

To estimate how much fibre your child needs per day, take their age and add 5 grams for the minimum and 10 grams for the maximum. For example, a 5-year-old should get a minimum of 10 grams and a maximum of 15 grams of fibre per day.

It's best for children to get their fibre directly from food rather than supplements. However, if your doctor recommends a fibre supplement, give it as directed.

• Choose whole grains instead of refined grains, such as brown rice instead of white rice or whole-grain pasta instead of regular pasta.
• Opt for whole fruit instead of juice.
• Include fruit and vegetables with every meal. Aim for 5 or more servings per day.
• Top yoghurt, cereal, or oatmeal with fruit and nuts.
• Put vegetables like lettuce, tomato, or avocado on sandwiches.
• Add beans to soups and salads.
• Offer air-popped popcorn, whole-grain crackers, fruit, or vegetables as healthy snacks.

When increasing fibre in the diet, it's important to also increase fluid intake. Water is the best source, but fluids can also come from healthy beverages and some foods. Clear or pale urine is a sign that your child is hydrated.

• Offer your child 100% fruit juice, such as apple, pear, or prune juice, which can help with constipation.
• Substitute half of the juice with water to increase overall fluid intake.
• Offer whole milk to 1–2-year-olds. For older children, switch to low-fat or fat-free milk.
• Offer plenty of water. You can flavour it with cut-up fruit, vegetables, or herbs if your child prefers.
• Offer fruits and vegetables that are high in fluids, such as grapes, watermelon, cucumbers, oranges, celery, strawberries, blueberries, and kiwis.
• Include low-sodium broths and soups at mealtimes.
• Provide fruit popsicles, Jell-O, or Italian ice as snacks.

Remember to introduce fibre into your child's diet slowly over a few weeks. A rapid increase in fibre intake may worsen constipation or cause gas, cramping, bloating, or diarrhoea.

Frequently asked questions