Syrups / Oral Laxatives for Constipation in an 11-Year-Old

1. Polyethylene Glycol (PEG) — First Choice

• Brand names: MiraLax, GlycoLax, MoviPrep
• Form: Powder dissolved in water/juice (acts like a syrup)
• Dose:
  • Cleanout/initial: 1–1.5 g/kg/day divided into 2–4 doses × 3 days
  • Maintenance: 0.78 g/kg/day once or twice daily
• Why: Safest, most evidence-based oral option. Tasteless, can be mixed in juice.

2. Lactulose Syrup

• Form: Sweet syrup
• Dose: 1–3 mL/kg/day in divided doses (typically 10–20 mL twice daily for a child this age)
• How it works: Osmotic laxative — draws water into the bowel
• Note: May cause bloating and gas

3. Senna Syrup (Senokot)

• Form: Liquid syrup
• Dose for 6–12 years: ~5–10 mL once or twice daily (follow pack instructions)
• How it works: Stimulant laxative — increases bowel movement
• Note: Good for short-term use; not for long-term without medical advice

4. Sorbitol Syrup

• Similar to lactulose, osmotic mechanism, often cheaper
• Dose: 1–3 mL/kg/day

5. Sodium Picosulfate Drops/Syrup (e.g., Lax-Q, Picolax)

• Stimulant laxative; available as drops or syrup
• For children >4 years: 2.5–5 mg once daily

For Acute Severe Constipation (ED/Hospital setting)

• Sodium phosphate enema: Pediatric 2.25 oz enema for children 2–11 years; adult 4.5 oz enema for >11 years

Dietary Measures (Always First)

• Increase fruits (prunes, papaya, pears), vegetables, and water intake
• Reduce processed foods and dairy excess
• Regular toilet time after meals

Quick Summary Table

Important: Always consult a pediatrician before starting any laxative in a child. If the child has not passed stool for >1 week, has severe abdominal pain, vomiting, or blood in stool, seek medical attention immediately.