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July 2013

Can laxatives cause poop accidents?

The mother of a child with encopresis recently told me that when she asked her pediatrician if Miralax might be the cause of her son’s frequent poop accidents, her pediatrician said, “Absolutely not!  In all my years of practice I have never seen Miralax cause accidents!” 

My first thought was that this doctor must not have treated many children with encopresis.

Any PEG or water retention laxative such as Miralax can cause stool to leak, sometimes uncontrollably, if given in unnecessarily high doses. This is, unfortunately, very common. In my experience, the main reason why children are unintentionally given more (or sometimes less) laxative than they need is because parents and even some healthcare professionals think that “one cap” of the PEG powder is the “standard dose” even for children, so that is how it is typically prescribed. But, often that is far more than the child needs.

The last thing a child (or their parent) wants is to soil or leak MORE than usual! In my experience, the most common reason parents feel that laxatives don't work for their child is that their child has been on an incorrect dose.

The fact is that there is no one dose that is correct for all children. A dose that works for one child may be too much or too little for another child. That’s why I always advise that PEG laxatives be prescribed by the teaspoon and not by the cap, keeping in mind that one cap equals five level teaspoons.  My book describes in detail how to determine the correct dosage for your child.

Recommended Products: Children's Potty

I have received requests to post useful poop-related products. Though the marketplace and brands are always changing,  I have been recommending certain types of products to my patients for years. The ones I will post are my current favorites.  Most are available on and in major stores such as Walmart, Target, Babysrus or Toysrus. 

Dr. Tom's Recommendation: Children's Potty



For children new to the potty or during potty training, I like the BABYBJÖRN Potty Chair shown above.  This version has a high back which provides a sense of security when teaching children to sit back and relax.  The high back and arms allow children to easily, slowly and carefully seat themselves. The high "splash" guard at the front of the interior bucket protects the floor and is especially useful with boys.  This seat comes in many different colors.