Did you know that every day children get prescribed a medication that has only been approved through the FDA for use in adults? Not only that, but it has only been approved in adults for SHORT periods of time- and by that I mean 7 days. SEVEN. DAYS. NOT seven weeks, not seven months, definitely not seven YEARS. Yet it’s happening. Every day. To millions of kids. What drug am I talking about? Miralax. Yep, Miralax. I’m sure you’ve heard of it. You may even have used or are currently using it for you or your child. The truth is, Miralax is everywhere in the parenting community. Constipation is a very common problem for little ones. As I’ve said before though, common does not mean normal. Most stats I’ve found have been very evasive as to exactly how common but one source did tell me that constipation occurs in 4-36% of children. Well now. That’s a really big range. 4% isn’t much to bat an eye at. But when we get up to 36% that’s over 1 in 3 children. That stat in addition to the fact that constipation costs the U.S. about $3.9 billion a year and we have a big problem.
Back to what I was saying. MIRALAX. The “miracle” drug. I have met children who have been on increasing doses of miralax since they were a couple of months old. The scary thing is that now these children are YEARS old. Go back to the first paragraph here. Miralax has been approved by the FDA for use in adults for seven days. I don’t know what to say here guys. If that simple sentence doesn’t resonate horror with you I’m not sure what will. But let me delve deeper. Miralax’s active ingredient is polyethylene glycol 3350. Although this is considered “generally safe” by the FDA, it is also used in rocket fuel, industrial products and the making of ceramics. If you look at the list of side effects associated with polyethylene glycol and Miralax you will see stomach pain, bloody diarrhea, gas and bloating, bleeding from the rectum, dizziness and sweating. But what is more interesting is that according to FAERS (the FDA’s Adverse Event Reporting System) there have been thousands of reports from parents of neurological side effects occurring (I call these “side” effects but let’s face it-they’re just plain EFFECTS). These neurological effects include: seizures, tremors, tics, headache, anxiety, lethargy, sedation, aggression, rages, obsessive-compulsive behaviors including repetitive chewing and sucking, paranoia, and mood swings. I would venture to say that those are much more alarming than stomach pain. So..THOUSANDS of reports. The FDA initially brushed this off as unrelated. In fact, when you look at their webpage on FAERS you’ll see this charming little abstract:
|Polyethylene Glycol (PEG) 3350 over-the-counter oral laxative|
|FDA decided that no action is necessary at this time based on available information.|
So you’re telling me that despite THOUSANDS of reports on something that is much more serious than a stomach ache and the FDA deems that “no action is necessary at this time based on available information.” When the company that produces Miralax, Bayer, was confronted about these findings and the question of safety in children, they responded with “Miralax is approved for use in adults for short term periods” in addition to extra fluffy comments about how devoted to safety they are. Fortunately, in September the FDA awarded nearly $325,000 to The Children’s Hospital of Philadelphia to study whether polyethylene glycol 3350 might be absorbed by the very young and whether use of the laxatives is linked to development of psychiatric problems. Really, in terms of research this is a small amount of money but at least we are moving forward with looking into what the potential risks are for children. Another interesting fact is that the same neurological symptoms being reported with children taken Miralax have also been documented when children have taken high doses of ethylene glycol. The FDA has even noted that some children taken Miralax long term have developed acidic blood which is also associated with taking ethylene glycol. Acidic blood. And no need to look into this further.
Here’s yet another problem with Miralax. There have been numerous reports that children who are on Miralax long term are unable to have a bowel movement without it. They become addicted to it. What’s the answer there? Just continue Miralax forever??
One of the most common responses I hear in respect to the dangers of Miralax are, “my pediatrician told me it’s safe. They would not tell me to give it if it was not safe.” Does anyone remember when doctors recommended cigarettes?? Or gave arsenic injections?? What about thalidomide? The drug that was given to pregnant women for pain and morning sickness that caused thousands of birth defects?? We need to remember that no care provider is infallible. This means that it is important for you to take yours and your child’s health into your own hands. Advocate for you and your child. Research everything. Ask questions. Most people do more research into what kind of TV they are going to buy than into their children’s health. Do not let this be the case for you. Do not be a proverbial lemming.
So as always, the best way to look at any problem is to break it down. What causes constipation? Well there are the obvious things- dehydration and diet. If your child is living off of chicken nuggets and poptarts, you may have a problem with constipation. But according to Mayo Clinic, other things such as changes in routine, medications, cow’s milk allergy, withholding and family history can all contribute. Withholding happens for a number of reasons. The main ones are either this: a parent forced their child into potty training before they were ready so the child is afraid of the toilet, a child does not want to take a break from playing to go to the restroom, or that the child has anxieties about public restrooms so will not use a toilet away from home. The family history one drives me nuts because unless there is an underlying condition, I hate the thought process of “well, your family has it, so you’re bound to have it and there’s really nothing you can do about it.” But here we hit an interesting question- why can you have a child who has a terrible diet and never get constipated and then a child who eats nothing but fruits and veggies who IS constipated? I’m a firm believer that most things are multi-factorial. As a pediatric chiropractor, it’s my job to find the root of the cause. So here’s the deal. Does diet factor into constipation? Yes! It absolutely does. Does all that other stuff factor in? Possibly, yes. But really, what controls the bowels and the ability of the body to poop? (Yes, I said poop) THE NERVOUS SYSTEM. Guys. I’m a broken record here but I want everyone to understand this basic bit of human anatomy that so often gets overlooked. Very simply put, the way that we poop is by the muscles of the colon work to not only mix food but also move it down to the rectum. The only way this happens is through the nerves. The nerves coordinate all the movements of the muscles. Still doubt me? What about when you are nervous? Let’s say you have to give a big talk to lots of people- what do most people end up doing? –running to the bathroom numerous times to poop. That’s all because of flight or fight brought on by your sympathetic nervous system. So if those nerves aren’t firing properly because of irriation, then those muscles will also not fire properly and we end up with poor plumbing and being backed up. So as a chiropractor, I am like your plumber. I can get you unplugged. Is your child suffering from constipation? Call. I can help. 281-719-9708 Or Dr. Krissy in our Woodlands office at 281-719-5004.