Bowel Clean Out With Miralax

Some conditions, such as severe constipation, may require a child have his or her bowel cleaned out. Our health care team has designed a bowel clean out program based on a patient’s weight. These instructions are to be followed by CHOC Children’s gastroenterology patients who have been instructed by our specialist to begin a bowel clean out regimen.

Your child weighs about:

Less than 22 pounds Give 1/3 capful, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
23 – 33 pounds Give ½ capful, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
34 – 44 pounds Give ½ capful, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
45 – 55 pounds Give ¾ capful, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
56 – 66 pounds Give 1 capful, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
67 – 77 pounds Give 1 capful, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
78 – 88 pounds Give 1 capful, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
89 – 99 pounds Give 1 capfuls, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.
100 – 110 pounds Give 1 ½ capfuls, 3 times each day for 2 days. Give at 8 a.m., noon and 4 p.m.

In addition to the Miralax, the child needs to drink one cup of liquid at least 8 times per day for the 2 days that they are on this clean out program. A cup is equal to 8 ounces of liquid. The child can eat food that is easy for their stomach to process for these two days. Good food choices include applesauce, yogurt, oatmeal, mashed potatoes, soup broth and toast with butter. Drinking a lot of clear liquids will often help them avoid feeling hungry. During the bowel clean out, please plan on being at home for three days because bowel movements will be frequent and hard to predict. It may take three days to completely cleanse the bowel. Once clean out is finished, give a dose of Miralax 1 time each day. The Miralax can be mixed with water or juice. The juice does not have to be clear. The dose is based on your child’s age (not weight):

Children under 5 years old Give ½ capful mixed into ½ to 1 cup of water or juice
Children 5 to 12 years old Give ¾ capful mixed in 1 cup of water or juice
Children 12 years old and older Give 1 capful, mixed in 1 cup of water or juice

One of our pediatric gastroenterology specialists may adjust the child’s dose based on how the program is working. When the child has soft but formed (Type 4 stool on the Bristol Stool Chart) and easily passable bowel movements each day, we know the program is working.

Bristol stool chart

Disclaimer: These instructions are general guidelines and should be used for informational purposes only, not medical advice. They are intended for CHOC Children’s patients. Specific instructions for your child may differ. Please follow instructions provided by your child’s physician and CHOC Gastroenterology staff.