For constipation:
Treating constipation is two-fold - first you need to remove the stool burden that has already built up
and then you need a good maintenance plan to prevent recurrence.
To remove the current stool burden, do a mini-clean-out at home.
1. Mix 3.5/7*** capfuls (=60/119*** grams) of Miralax with 16/32*** ounces of Gatorade
3. Drink Miralax/Gatorade mixture over the next 2 hours.
(Can keep portion not being drank in the fridge, or else it becomes a little grainy.)
This plan will make your child poop for a few hours - you should do this on a day when he/she can be
near home and near a bathroom.
Constipation maintenance plan (i.e.daily plan to prevent constipation), you should:
• Miralax *** grams (=*** capful) per day
• Goal is a soft oatmeal consistency BM at least once daily (Poop that looks like logs with cracks,
bumpy logs, or individual balls/pellets of stools is too constipated)
• This is a safe medication that you can easily adjust at home to achieve the desired effect.
• To decrease the dose for loose stools, decrease by 1-2 tsp per day no more often than every 3
days as needed.
• To increase the dose for hard stool, you can increase by 1-2 tsp per day every day as needed.
• Your child will need to be on Miralax daily to prevent constipation for a minimum of 3-6 months;
if after that time, his/her diet and fluid intake have changed and he/she is not needing very
much Miralax (1/2 capful per day or less), we can try discontinuing this medication.
If your child continues to require more than 1 capful of Miralax per day after 3-6 months, we should
reassess his constipation and make sure there's not something more going on.
Other tips for Constipation Management:
• Encourage lots of fluids (goal of at least 1.5 liters or 50 ounces per day of uncaffeinated fluids)
• High-fiber diet.
• Develop a regular stooling schedule. There is a natural reflex in the body to have a bowel
movement after eating. To take advantage of this, have your child sit on the toilet for at least
10-15 minutes after every meal. (During the school year, you can alter the schedule so that it is
after meals at home only).
• If your child feels like he/she has to stool, he/she should try (some kids will hold stool in at
school or at other inconvenient times - he/she shouldn't do this given his/her history of trouble
with severe constipation).
• If your child is embarrassed about constipation problems, consider developing a "code word" so
that he/she can tell you at any time or in any place that he/she is having issues and you can
discuss them privately.
