Q: I gave my son a recommended dose of Pedia-Lax based on his age. How long should I wait until I can give him the next dose if he has not had a bowel movement yet?

A: The maximum recommended dose that can be given per product differs based on the type of product and the age of your child. You should follow specific guidelines based on the product you are using. I recommend that you start with the lower end of the dosing range, and increase the dose if there is no reaction after the reaction time listed on the carton. For example, if you are using Pedia-Lax Chewable Tablets and your child is 6 years old, you may use a starting dose of 3 tablets. If there is no bowel movement after ½ to 6 hours, you can give more tablets, remembering not to exceed the maximum daily dose of 6 tablets for children 6 to 11 years. Another example is that you should only give your child one sodium phosphates enema within a 24-hour period.

Please note: If your child doesn't have a bowel movement within the reaction time after the maximum dose has been given, contact your pediatrician. Contact your pediatrician if your child doesn't have a bowel movement after 30 minutes of giving the Pedia-Lax saline enema.

Q: My child recently started a new school and hasn't gone to the bathroom in days. But, she sometimes has loose stools in her pants. If she was constipated she would not soil her pants, right?

Not necessarily. A child who suffers from constipation does not have the same control over their rectal muscles as an average child without these issues. She could have a very hard, large stool that is difficult to pass within her rectum and loose stool passes around the lodged stool. Constipation can present as loose stools and soiling in between periods of having no bowel movements. Furthermore, the fact that the child just started school could indicate anxiety about the new school, using a public bathroom, being separated from parents/caregivers, etc. These stressful situations could and often do, cause constipation.

Q: We have used laxatives before but they hardly worked. We stopped using them. Now the constipation has returned and we do not know what to use.

A: If a constipation remedy did not work, the correct dose was probably not used. Although the doses are recommended by age, some children may need to use more or less according to their condition. Your child's pediatrician can best advise what's right for your child. After the initial episode of constipation is resolved, changes in diet should be instituted to help maintain regularity. If constipation persists after changes in diet and dosing, you can try the remedy at the appropriate dose once again. All of these steps should be done under the supervision of a pediatrician.

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