Natural Alternatives to MiraLAX (And Why They’re Not the Long-Term Answer)

One of my most common questions from parents is regarding natural MiraLAX alternatives! While this is a great question, both MiraLAX and other natural osmotic laxatives are a short-term solution to tackling the larger task of getting to the root cause of your child's constipation!

Let’s take a peek at how MiraLAX works, two natural alternatives I often recommend, and why these options should only be considered as temporary support while addressing the cause behind your child’s constipation.

What is MiraLAX?

MiraLAX is classified as an osmotic laxative. It works by drawing water into the colon to soften stool so it is easier to pass.

The most common example I like to give parents is this:  Imagine a water slide with a tube but no water — everything would get stuck. But if you add water the tube becomes slippery, and things move through much more easily.

That’s essentially how MiraLAX works inside the body by pulling water into the colon so stool can slide through easier. 

Natural Alternatives to MiraLAX

When we're looking for alternatives, we want options that are natural osmotic laxatives — meaning they also draw water into the colon, but without all the side effects that MiraLAX may sometimes bring.

Two of my favorite natural options are:

• Magnesium Citrate is a naturally occurring mineral. When taken orally, magnesium citrate draws water into the intestines, which softens stool and makes it easier to pass. I typically use this for children ages 2 and older in oral form.
• Prune Juice is a gentle option I recommend for children ages 6 months to 2 years. When choosing prune juice, look for high-quality, organic, cold-pressed juice (not from concentrate) with no added sugars. Prune juice naturally contains sorbitol, a sugar alcohol that helps pull water into the intestines and soften stool.

Both options work similarly to MiraLAX in terms of softening stools — but again, they are best used as short-term tools while we work to find and address the true root causes of constipation!

Why I do not use MiraLAX in my practice

I always want parents to choose what feels right for their family. That said, I believe it's important to be informed about why MiraLAX is controversial, especially in the pediatric population. I will also attach all sources below so you can dive into it more and make the best decision for your family!

Here’s why I don't use MiraLAX at Wholesome Littles:

• MiraLAX is not FDA-approved for children, and it's not approved for use beyond 7 days — even in adults.
• Many providers recommend daily long-term use, often for weeks, months, or even years. This use is considered "off-label" — meaning the doctor is using their own clinical judgment to recommend a medication outside of its official FDA approval.
• In response to parent concerns about behavioral changes and neuropsychiatric symptoms, the FDA is currently funding a study to investigate the safety of MiraLAX use in children.

While I have worked with families whose children tolerated MiraLAX well, I have also worked with families who reported changes with their child after starting it. I firmly believe that parents know their children best and always want them to feel heard. My role will always be to support families without judgment, whatever health journey looks like for them. 

For all these reasons, MiraLAX is not a tool I use as part of my constipation protocols.

Why I Do Not Support Long-Term Laxative Use in Children (in Any form)

If a child needs a laxative for an extended period of time, it's a sign that something deeper is going on — and it's important to find the root cause. Something is triggering the stool to harden in the first place, and using MiraLAX or any other osmotic laxative is only masking the symptom, not addressing the real issue.  It’s much more productive — and healthier for the child — to uncover and treat what’s causing the constipation, rather than relying on ongoing laxative use.

Here’s a simple way to think about it: If your kitchen sink is clogged, pouring more water into it won’t fix the problem.  It might temporarily help things move along, but unless you actually clear the clog, the issue will keep coming back. Constipation is the same way. We need to clear the underlying cause!

Another reason I avoid long-term laxative use is the emerging research suggesting that extended use of osmotic laxatives may disrupt the gut microbiome and contribute to increased intestinal permeability (often called “leaky gut”). I believe in building the gut up, not breaking it down — because the gut is the foundation for so many aspects of a child’s health.

How Osmotic Laxatives Should Be Used – Correctly

Osmotic laxatives can be incredibly helpful for children struggling with constipation — especially when compared to more invasive options like suppositories, enemas, or stimulant laxatives.

In my practice, I often turn to gentle osmotic support when a child is showing signs of stool withholding or has hard, dry stools that are painful or difficult to pass while we work on the underlying root cause.

It’s important that we keep things moving to avoid major backups or fecal impaction, and osmotic laxatives can be a great tool to do just that.

Every child is different, but some of the most common root causes I see include:

• Dietary triggers
• Dysbiosis, or an imbalanced gut microbiome
• Poor core strength or pelvic floor dysfunction
• Unaddressed stool withholding behavior 

All this to say, the goal of all my posts (this one included!) is to make sure you have all the facts before you make health decisions for your little one! You deserve to feel confident in whatever path you take — and whatever that decision is, trust that it’s the right one for you and your child!

xx,
Clare

References

• U.S. Food and Drug Administration. Polyethylene Glycol 3350 Label. Drugs@FDA. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=078028

• Research at CHOP. Polyethylene Glycol Safety in Children Study. Children’s Hospital of Philadelphia. https://www.research.chop.edu/polyethylene-glycol-safety-in-children

• Tropini, C., Moss, E. L., Merrill, B. D., Ng, K. M., Higginbottom, S. K., Casavant, E. P., Gonzalez, C. G., Fremin, B., Bouley, D. M., Elias, J. E., Bhatt, A. S., Huang, K. C., & Sonnenburg, J. L. (2018). Transient osmotic perturbation causes long-term alteration to the gut microbiota. Cell, 173(7), 1742–1754.e17. https://doi.org/10.1016/j.cell.2018.05.008

• Moeser, A. J., Nighot, P. K., Roerig, B., Ueno, R., & Blikslager, A. T. (2008). Comparison of the chloride channel activator lubiprostone and the oral laxative polyethylene glycol 3350 on mucosal barrier repair in ischemic-injured porcine intestine. World Journal of Gastroenterology, 14(39), 6012–6017. https://doi.org/10.3748/wjg.14.6012

• Lin, T. L., Wu, C. Y., Fan, Y. H., Chang, Y. L., Ho, H. J., & Chen, Y. J. (2022). Association between early life laxative exposure and risk of allergic diseases: A nationwide matched cohort study. Annals of Allergy, Asthma & Immunology, 128(3), 291–298.e3. https://doi.org/10.1016/j.anai.2021.12.016