Understanding Safe Laxative Use For Children

Laxatives are a group of medications designed to relieve constipation, making it easier to pass stool. They are available in oral and rectal forms. While laxatives are a safe solution for children's occasional constipation, it is important to be cautious about the dosage and type of laxative administered. The FDA has recently raised concerns about the use of PEG 3350 laxatives in children, as they contain small amounts of ethylene glycol and diethylene glycol, which could potentially lead to side effects. However, these compounds are considered safe at very low levels, and the benefits of using PEG 3350 laxatives may outweigh the risks for children with severe constipation. It is always recommended to consult a doctor or pediatrician to determine the best course of treatment for a child's constipation.

Laxatives are medicines that help the body get rid of poo

There are four ways that laxatives work:

• Stool softeners add moisture to the stool, so it isn't as hard.
• Osmotic laxatives increase water in your intestines, so that hard stool passes more easily.
• Lubricant laxatives coat the stool, so it is slippery and easier to pass.
• Stimulant laxatives work to stimulate the rectal muscles and help push the stool out.

It is important to follow dosage instructions closely and not give more than one type of laxative at a time. You should also monitor the frequency of laxative dosages, as you do not want your child to become dependent on laxatives for passing stool.

Laxatives are necessary until the body can manage a daily soft poo without help. Children often need laxatives for months to years rather than weeks. Ideally, your child should aim for one soft poo every day that is not painful to pass.

Lactulose, sodium picosulphate, and macrogol are the most common and effective laxatives for children with constipation. Lactulose is a liquid and the most common medicine for constipation in children. It may taste better if chilled or mixed with juice or milk. Sodium picosulphate is a liquid medicine given as drops that are tasteless and colourless, making it easier for children to take. Macrogol is a powder mixed with liquid, particularly good for children with very hard or impacted poo.

Laxatives are available in oral and rectal forms

Laxatives are medicines that help treat constipation by softening hard stools or stimulating the bowels to move. They are available in oral and rectal forms. Oral laxatives can be taken in the form of pills, powders, liquids or syrups, and rectal laxatives can be administered as suppositories or enemas.

Oral laxatives come in a variety of formats. Pills are the most common form, with capsules or tablets taken by mouth. Powders are another option, which can be mixed with water or other liquids and then consumed. Liquids or syrups are also available, which can be measured out and drunk directly. These oral treatments are typically used for adults, as children often struggle with the taste or get tired of taking medicine.

Rectal laxatives, on the other hand, are inserted directly into the anus. Suppositories are tiny dissolvable capsules that contain the laxative. Enemas, on the other hand, are small squeezable tubes that are injected into the anus to deliver the medicine. These rectal treatments are generally faster-acting than oral treatments, often providing relief within minutes or hours. However, they also carry a greater risk of side effects such as diarrhoea and stomach cramps.

When it comes to children, it is important to consult a doctor or paediatrician before administering any laxative. While laxatives are necessary for treating long-lasting constipation, they should only be used under medical supervision and for as long as necessary. The goal is to help the child develop a normal habit of pooing regularly without pain. Common laxatives for children include lactulose, sodium picosulphate and macrogol, which are effective in treating constipation and can be administered as liquids or drops.

Signs and symptoms of constipation

Constipation is a common problem in children and can be the result of a number of factors, including changes in diet, early toilet training, and not drinking enough water. It's important to recognise the signs and symptoms of constipation in children, as this can help alleviate their discomfort and prevent further issues. Here are some of the most common signs and symptoms:

Infrequent Bowel Movements

One of the key signs of constipation is having fewer than two or three bowel movements per week. This can vary depending on the child's age, as babies may have a different pattern. However, if you notice your child going less than their usual number of times, it could be a sign of constipation.

Hard and Dry Stools

Constipated children often pass stools that are hard, dry, or lumpy. These stools can be difficult or painful to pass and may cause bleeding during bowel movements. Look out for blood on the surface of the stool or on toilet paper.

Stomach Pain and Bloating

Children with constipation may experience stomach pain and bloating. They might also feel full or complain of a swollen abdomen. This is often due to the buildup of stool in the rectum, which can cause discomfort.

Traces of Stool in Underwear

Another sign of constipation is finding small marks or stains of stool in your child's underwear. This is sometimes referred to as "encopresis." It occurs when impacted stool leaks out, indicating that the child is having trouble fully controlling their bowel movements.

Avoiding or Delaying Bowel Movements

Children who are constipated may try to avoid or delay having a bowel movement. They might do this by standing on their tiptoes, clenching their buttocks, or making unusual movements. They may also express fear or discomfort associated with having a bowel movement.

Behavioural Changes

In some cases, constipated children may exhibit behavioural changes. They might cross their legs, twist their body, or make faces in an attempt to hold in their stool. They might also become fearful of using the toilet, especially in public places, or worry about having a painful bowel movement.

If you notice any of these signs and symptoms in your child, it's important to address them promptly. Encourage your child to drink plenty of fluids, increase their fibre intake, and develop a regular toilet routine. If constipation persists or is accompanied by bleeding, abdominal pain, or rectal prolapse, consult your child's doctor for further advice and treatment options.

Causes of constipation

Constipation is a common problem for children, with around 18% of toddlers and 14% of children and teens suffering from it. It is often temporary, but it can become a long-term issue. Constipation occurs when a child has very hard stools and has fewer bowel movements than they normally do. The number of bowel movements may vary for each child, but it is often defined as having fewer than three bowel movements a week.

There are many reasons why a child may become constipated. Here are some common causes:

• Diet: A diet lacking fibre and fluids is a leading cause of constipation. Eating too many processed, high-fat, and low-fibre foods, such as fast food, junk food, and soft drinks, can contribute to constipation. Children should aim to consume 20 to 25 grams of fibre each day from fruits, vegetables, and whole grains. Additionally, excessive dairy intake has been associated with constipation, so reducing dairy-rich foods like cheese and milk may help.
• Lifestyle and Routine changes: Small changes in a child's routine can impact their bowel habits. For example, travelling, starting a new school, or spending more time away from home can disrupt their regular bathroom habits. Children may be scared to use new bathrooms or simply miss the signals that they need to go due to changes in their schedule.
• Toilet training: This can be a challenging time for toddlers, and they may feel anxious or reluctant to use the toilet, leading to withholding stool.
• Lack of exercise: Inadequate physical activity can contribute to constipation. Exercise helps move digested food through the intestines, so encouraging children to play outdoors instead of watching TV or playing video games can improve their digestion.
• Emotional factors: Stress and anxiety can affect digestion and lead to constipation. Children may feel stressed due to potty training, starting a new school, or social situations. Helping them identify stress triggers and teaching them relaxation techniques can improve their mental and digestive health.
• Medications and supplements: Certain medications and dietary supplements can slow down the bowels and cause constipation. Antacids containing aluminum and calcium, anticholinergics, antispasmodics, anticonvulsants, narcotic pain medications, and some antidepressants are among the drugs that can worsen constipation.
• Underlying health conditions: In rare cases, constipation can be a symptom of a larger physical problem, such as intestinal tract issues, rectal problems, nervous system disorders (e.g., cerebral palsy), endocrine problems (e.g., hypothyroidism), or metabolic conditions (e.g., diabetes).

Diet and lifestyle changes to prevent constipation

It is important to consult a doctor or paediatrician about the use of laxatives for children. While laxatives are an essential part of treating long-lasting constipation, they should only be used under medical supervision.

Diet and lifestyle changes can help prevent constipation in children. Here are some recommendations:

• Ensure your child is drinking enough water and other liquids. Liquids help the fibre work better and keep the body hydrated, which is essential for good health and can help prevent constipation. The amount of liquid a child needs will vary depending on their size, health, activity level, and the climate.
• Increase your child's fibre intake. Depending on their age and sex, children should get 14 to 31 grams of fibre per day. Good sources of fibre include whole grains (such as whole wheat bread and pasta), oatmeal, bran flake cereals, legumes (such as lentils and beans), fruits (such as berries, apples, oranges, and pears), vegetables (such as carrots, broccoli, and green peas), and nuts. Introduce fibre to your child's diet gradually and ensure they drink enough liquids to help it work effectively.
• Avoid foods with little to no fibre, such as prepared frozen meals, snack foods, and processed foods (like hot dogs and microwavable dinners).
• Encourage your child to get enough exercise. Physical activity helps stimulate the bowels. Simple activities like walking, playing catch, riding bikes, or playing sports can help prevent constipation.
• Develop a regular meal schedule. Eating is a natural stimulant for the bowels, so regular meals may help your child develop routine bowel habits.
• Establish a bathroom routine. If your child resists the urge to go to the bathroom, have them sit on the toilet for at least 10 minutes at the same time every day, ideally after a meal.

Frequently asked questions