My toddler is constipated. Their doctor recommended Miralax (or similar). What should I do?

May 3, 2025 — Saturday
What I have written below is in response to a question from a Lead Safe Mama community member.

I personally refused to use anti-constipation over-the-counter (or prescription) products with my kids early on once I learned the following:

1. 1. Constipation is a typical outcome of Lead exposure that needs long-term, healthy, sustainable options for management. It is not something that can be fixed “temporarily” with an over-the-counter medication that may have terrible side effects, and…
  2. These over-the-counter (and prescription) laxative products can be incredibly toxic (in fact, given their ingridient profiles, they can actually be contaminated with Lead and other heavy metals).

Instead of using these products I focused on aggressively changing my kids’ diets and creating healthier routines for them to make sure they could poop normally and without pain/ discomfort or bleeding.

While you should always talk to your doctor about these issues and get their advice first (over some unknown source on the internet), I do recommend getting a second opinion from a new/ different doctor if they recommend Miralax or a similar product. My personal advice (how I handled this issue with my own children) is below (and, to reiterate what I have said in many places on this website, I am not a doctor nor healthcare provider — I share food-based intervention from personal experiences that should be evaluated on their own merits in conjunction with the advice from your doctor).

Our advice, from a heavy metals perspective, is never using these products (that aid in elimination) except perhaps in a medical emergency and with supervision from a doctor. If at all possible, parents should focus on diet/ food-based interventions.
Our understanding (based on independent research and anecdotal evidence shared with us by other parents of Lead-poisoned children over the past two decades) is that using these products has the potential to create a long-term dependence on them (sometimes creating a situation where children entirely miss/ misunderstand natural elimination cues as a result, requiring them to use diapers and other interventions into their early teen years — and even beyond).
Dependence on elimination aids happens often with Lead-poisoned kids because these children often have life-long GI issues (GI complications are a primary symptomatic impact of Lead poisoning) — and American doctors do not generally focus on dietary changes and nutrition evaluations when looking for remedies.
Over-the-counter (and prescription) elimination aid products also can test positive for heavy metals and using them persistently can actually cause chronic heavy metal exposure and be a compounding factor in related health issues (specifically GI issues).
INSTEAD, TRY THESE SOLUTIONS: Consider making the following changes to your child’s diet for a week or two and see if it helps.
1. BLUEBERRIES: Get the frozen organic blueberries from Trader Joes or similar (the tiny, wild ones) and serve a cup of frozen blueberries each morning (with a little bit of cream and a tiny sprinkle of sugar if your child does not like them plain).
  - Blueberries provide great healthy fiber, are easy to chew (even for toddlers), and will get their day started off right.
  - If you add cream, it freezes on top and turns it into an ice cream type treat, but make sure to use only a small amount of cream — for example, for one cup of blueberries use only a tablespoon or two of cream and 1/4 to 1/2 teaspoon of sugar (or honey drizzled from very high up, which is always entertaining for toddlers) while they watch you sprinkle it so they know it is sweet (sort of a trick to convince them to eat it vs. actually adding a substantive amount of sugar).
  - Always use fresh blueberries when in season if your kids like them! Wash well before serving.
  - My kids preferred the frozen blueberries any time of year, plus it is easy to have them on-hand (we would buy 10 bags at a time when they were little)!
2. APPLES: After the first few days of adding blueberries into their daily routine, add in the “apple a day” policy. Make sure your child has at least one apple each day before they eat any bread or flour product/ flour-based snack, or (if an apple before is not possible) make sure they eat an apple after they eat any bread or flour-based snacks.
  - The apple should be eaten daily regardless of bread and flour product consumption (we generally recommend avoiding ALL bread and flour products, including things like crackers and chips, especially for constipated kiddos).
  - Avi (my son, who was acutely Lead-poisoned at just 7-months-old and is now 20-years-old) generally eats two or three apples throughout the day as his snack (since they are easy to carry with him in his school bag).
  - Try different ways of serving your child’s apples!
    - Slice the apple thin,
    - slice it spiral
    - slice in thick wedges…
  - As your child grows, make sure the apples you give them daily grow, too. (Bigger kids = bigger apples!)
    - We’re lucky in Oregon that we have a wide variety of healthy, natural, organic apples available year round — and I do understand that others do not have the range of choice that we have, so do your best on this front!
  - Make choosing and eating apples a fun tradition/ part of your child’s routine:
    - Have your kiddo choose the apples at the market.
    - Buy examples of all of the different types of apples with them and do a taste-test comparison with them as a fun game.
    - After your taste test game, let them choose which apples they will have for their daily routine (and let them vary it). This gives them buy-in to the process, especially for smaller kiddos!
    - Remember: Your kids might like different things than you, and that’s ok! I love Honey Crisp and Fuji apples. Avi likes the sour green Granny Smith apples (which I cannot stand)! Lol.
3. CARROTS: Then -— once the “apple-a-day” concept is integrated into your child’s daily routine (where they are not fighting or questioning it) — add in a cup or more a day of baby carrots (they don’t have to be the store bought ones, instead you can cut your own from bigger carrots at home so you don’t have the bleaching/ washing concerns that come with packaged, processed baby carrots).
  - Carrots should always be well-washed and thoroughly peeled, especially for smaller children.
  - If you are chopping your own baby carrots, make each carrot stick about the size/ volume of one of the store-bought baby carrots.
  - My family has the following carrot rule: Each child must consume one small carrot stick (or baby carrot) for each year of their age plus one extra — so your 4-year-old would eat five carrots if you decide to implement this rule. It really worked for my family, to the point where my older teenagers would still follow the rule (for example, a 14-years-old still eating 14+1 carrot sticks)!
  - Explain the age +1 policy to your kids — this helps them feel like they have some control over how much they are required to eat and lets them know it is always predictable.
  - We ended up using the carrot policy for a lot of other situations, too:
    - Do they want a special treat at a birthday party? They need to eat their age +1 in carrots BEFORE they eat the treat.
    - Do they want to play a special game at home with mom? They need to eat their age +1 in carrots BEFORE we play the game.
    - Do they want to go out on a special outing or walk? Bring their age +1 in carrots to eat on the walk/ during the outing.
    - Do they want to leave the table before finishing dinner (or lunch)? Then they must eat their age +1 in carrots beforehand.
4. CUCUMBERS: Later, see if you can add raw, washed cucumbers into their diets (small whole ones if they prefer them, or thin/ thick slices with red wine vinegar if they prefer that).
  - If they like whole natural pickles you can add in one of those a day, too (like Bubbies), but no more than one a day for toddlers.
    - NOTE: Don’t use balsamic vinegar, as that can test positive for unsafe levels of Lead.
5. SMOOTHIES: Then add in a smoothie each morning — or after school. (Start adding this in after you have the blueberry routine mastered.)
  - For the smoothie, do NOT have it be juice-based. Try to blend whole strawberries, apples, blueberries, and mangos (or whatever other frozen and fresh fruit your kids like) with water and ice — but NO bananas.
6. AVOID THESE ITEMS: In general, avoid the following foods for at least the first week of this process until your kids are pooping regularly again. Even then, only let them have these things sparingly:
  - Cereal
  - Bread
  - Crackers
  - Puffs
  - Chips
  - Cookies
  - Homemade or store bought baked goods
7. OATMEAL: Instead of any kind of boxed cereal, give them organic oatmeal every morning.
  - If you feel that making fresh oatmeal is too much work/ too much for your already busy routine as a parent, cheat at first and let them help mix organic instant oatmeal packs for their own breakfast (so they have a say in that, too)! Giving children opportunities for autonomy in this way — with guidance! — supports healthier eating habits long-term!
    - Let your children try different brands and flavors (similar to the apple taste test)!
    - Let them choose the brand and flavor they like best and vary it if they want to try other products.
    - Any kind of oatmeal is ALWAYS a better choice over boxed cereal (for constipated kids), no matter what the other concerns are.
  - After you get that oatmeal routine going (replacing any cereal with oatmeal), graduate up to non-instant, home-made oatmeal — rolled oats, not quick oats.
KEEP UP THE ROUTINE: Once things become a routine, they become easy to implement (and little kiddos love routine and predictable situations). After a week of daily blueberries (alongside the routine shared above, folded in over the following weeks), your children should be making good poops, without straining or blood (especially at 4-years-old).
- Never stop the routine.
- Make it part of your daily life.
- Increase the opportunities for consuming fresh, whole food, and raw veggies in your kiddo’s daily life, adding in some of these organic ingredient options as well:
  - Bell peppers (red, orange, and yellow)
  - Grapes (kids prefer seedless)
  - Cherries
  - Pears
  - Apricots
  - Nectarines
  - Plums
  - Celery sticks

Good luck! If you implement these daily routines (gradually) into your child’s diet, they should be pooping normally every day within a week or two. There are safer choices for oats, sugar, and red wine vinegar for the cucumbers (and other lab-tested safer foods we have discovered through the Lead Safe Mama, LLC community collaborative laboratory testing initiative) featured in the list below.

Are you interested in seeing MORE safer choices?

Below is an expanding list of products (foods, supplements, cosmetics, and personal care items) that have tested “non-detect” for Lead, Mercury, Cadmium, and Arsenic with independent, third-party, community-funded laboratory testing coordinated by Lead Safe Mama, LLC (an Oregon-based small business with a unique community-collaborative business model and a focus on consumer goods safety and childhood Lead poisoning prevention). The product examples below clearly demonstrate that companies can manufacture safer choices (at least from the perspective of a concern for heavy metals contamination).
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The limits of detection (low-threshold of detection) for each of the metals tested can be found in the lab report for the specific product listed. To see the full original lab report for any of these products, type the brand name into the search bar at the top of any page on Lead Safe Mama dot com (and scroll down to the bottom of the related article). All of our published lab reports are also found linked here, on our lab testing landing page.
–
Flavors (or specific variations) tested are noted, and other flavors of the same product (or other products from the same brand) have either not been tested or have been tested but did not yield similar results. Test results only apply to the specific products linked below.

For those new to the Lead Safe Mama website:

Tamara Rubin is a multiple-federal-award-winning independent advocate for childhood Lead poisoning prevention and consumer goods safety, and a documentary filmmaker. She is also a mother of Lead-poisoned children (two of her four sons were acutely Lead-poisoned in 2005).

Tamara owns and runs Lead Safe Mama, LLC — a unique community collaborative woman-owned small business for childhood Lead poisoning prevention and consumer goods safety.
Since July 2022, the work of Lead Safe Mama, LLC has been responsible for six product recalls (FDA and CPSC).
All test results reported on this website are science-based, accurate, and replicable.
Please check out our press page to see some of the news coverage of our work, linked here.

LIST UPDATED April 28, 2025
Now at 67 products + 6 “bonus” options. Scroll down to see all 73 Lab-Tested Safer Choices:

Baby Food — 1 — Little Spoon Kale, Carrot + Pear BabyBlends
Baby Food — 2 —Little Spoon Butternut Squash + Blueberry BabyBlends
Baby Food — 3 — Little Spoon Sweet Potato BabyBlends
Baby Food — 4 — Little Spoon Sweet Potato + Carrot BabyBlends
Baby Food — 5 — Little Spoon Banana + Pitaya BabyBlends
Beverage — 1 — Honest Kids Organic Appley Ever After Apple Juice Drink: https://amzn.to/4fjGhov
Beverage — 2 — Olipop Grape Tonic: https://amzn.to/4cjFYZu
Breakfast Item — 1 — Nature’s Path Envirokidz Organic Panda Puffs: https://amzn.to/4fo1crf
Breakfast Item — 2 — Nature’s Path Envirokidz Organic Corn Puffs Gorilla Munch: https://amzn.to/3FHZCDO
Breakfast Item — 3 — One Degree Organic, Gluten-Free, Sprouted Rolled Oats (Canada): https://amzn.to/3WIQ1BN
Candy — 1 — Lindt White Chocolate Bar (Made in USA, New Hampshire): https://amzn.to/3OXkyIm
Candy — 2 — Cavendish & Harvey Wild Berry Drops, not organic (Germany): https://amzn.to/3Z1Jxjr
Coffee & Tea — 1 — Chameleon Handcrafted Organic Cold Brew Concentrate: https://amzn.to/3OcrH77
Coffee & Tea — 2 — Tao of Tea Organic Genmaicha (Tamara’s favorite, from Japan, sold by a Portland, Oregon-based company!): https://amzn.to/3Dp8Fsd
Coffee & Tea — 3 — Califia Farms Almond Latte Cold Brew (XX Espresso): https://amzn.to/4gTTGoJ
Coffee & Tea — 4 — Death Wish Organic Espresso Roast Ground Coffee (Multi-country origin, non-USA): https://amzn.to/3yo1eiL
Coffee Creamer, Plant-Based — 1 — Laird Superfood Coconut Creamer: https://amzn.to/4fItA7A
Coffee Creamer, Dairy — 2 — Organic Valley Grassmilk Half and Half: https://amzn.to/4fHJIWT
Dairy, Cheese — 1 — Babybel Mini Original Snack Cheese: https://amzn.to/3ZY5noO
Fruit Snack — 1 — GoGo Squeez Organic Apple Sauce Pouch: https://amzn.to/3XhWYLe
Fruit Snack — 2 — Costco’s Kirkland Organic Apple Sauce Pouch: https://amzn.to/4gOYpZ9
Fruit Snack — 3 — Pure Organic Layered Fruit Bars in Strawberry Banana Flavor: https://amzn.to/3WQEekA
Fruit Snack — 4 — Once Upon A Farm Dairy Free Fruit Smoothie Pouch in Strawberry Banana Swirl Flavor: https://amzn.to/3CPMbAw
Fruit Snack — 5 — Pure Organic Layered Fruit Bars in Raspberry Lemonade Flavor: https://amzn.to/3XcFsIp
Infant Formula — 1 — Bobbie Organic Gentle Infant Formula Milk-Based Powder with Iron (pink and white can): https://amzn.to/3YYb849
Infant Formula — 2 — Bobbie Organic Infant Formula Milk-Based Powder with Iron (green and white can): https://amzn.to/3VOr4Vy
Infant Formula — 3 — Bobbie Grass-Fed Milk-Based Powder with Iron (green can): https://amzn.to/3ZlAaeJ
Infant Formula — 4 — ByHeart Infant Formula (USA-made, not organic): https://amzn.to/48DJjTb
Infant Formula — 5 — HiPP Bio Combiotik Infant Formula Powder, Stage 1 (imported)
Infant Formula — 6 — HiPP HA Stage PRE (0+ Months) Combiotic Formula (imported)
Infant Formula — 7 — Holle Bio Goat Stage 2 Infant Formula (for 6-10 months, organic, European — Swiss/ German/ Austrian) is not available on Amazon, but the Stage 3 version of this product is (not yet tested, but will likely test similarly): https://amzn.to/3BVU7zI
Infant Formula — 8 — Kendamil Goat Infant Formula (not organic): This product may be available at Target (it is not available on Amazon)
Infant Formula — 9 — Kendamil Organic Follow-On Milk (European/ British Toddler Formula, for 6-12 months, Cow Milk): Not available on Amazon (report link)
Infant Formula — 10 — Kendamil Whole Milk Infant Formula (from Europe, pink can, not organic), available at Target
Infant Formula — 11 — Kendamil Organic Infant Formula (Cow Milk): Not available on Amazon but may be available at Target
Ingredient — 1 — (salt) — Jacobsen’s Sea Salt (Oregon, USA): https://amzn.to/4dcbk5L
NEW! Ingredient — 2 — (salt) — Maldon Sea Salt Flakes**: https://amzn.to/4iTzWTE
NEW! Ingredient — 3 — (salt) — Diamond Crystal Kosher Salt** : https://amzn.to/4cVQMiy
Ingredient — 4 — (baking flour) — Jovial Organic Einkorn Flour (Italy): https://amzn.to/3LIqxix
Ingredient — 5 — (seeds) — Costco Kirkland Organic Hemp Seeds: https://amzn.to/4e05RP9
Ingredient — 6 — (seeds) — Navitas Organic, Gluten-Free Chia Seeds (Mexico): https://amzn.to/3YvE7xC
Ingredient — 7 — (vinegar) — Napa Valley Naturals Organic Red Wine Vinegar (California): https://amzn.to/4jWhHOg
Ingredient — 8 — (beans) — Jovial Organic Chickpeas, Product of Italy: https://amzn.to/4iRON1l
Ingredient — 9 — (sugar) — Anthony’s Organic Granulated Cane Sugar: https://amzn.to/4jf6vLv
NEW! Ingredient — 10 — (sweetener) — Espure Organic Xylitol**: https://amzn.to/3GsCSrU
NEW! Ingredient — 11 — (sweetener) — Now Foods Xylitol**: https://amzn.to/4cNWDpM
Oil — 1 — Chosen Foods 100% Avocado Oil (not organic): https://amzn.to/3YDZSuv
Oil — 2 — Dr. Adorable’s Organic Perilla Seed Oil (Korea): https://amzn.to/3NDt7Yc
Oil — 3 — Dr. Bronner’s Regenerative Organic Coconut Oil: https://amzn.to/40xwBmv
Plant-Based Milk — 1 — Kiki Milk Organic Plant-Based Milk (original flavor): https://amzn.to/3AA6Qrt
Plant-Based Milk — 2 — West Soy Unflavored Unsweetened Organic Soy Milk: https://amzn.to/4dwev8l
Supplement — 1 — Baby Ddrops, Organic Vitamin D3 Supplement for Babies: https://amzn.to/49C3ktH
Supplement — 2 — Doctor’s Best Vitamin C with Q-C: https://amzn.to/4hlVvea
Supplement — 3 — Mary Ruth’s Organic Toddler Multivitamin Liquid Drops with Iron: https://amzn.to/3YPhcgx
Supplement — 4 — Mary Ruth’s Organic Toddler Elderberry Liquid Drops: https://amzn.to/42617TU
Supplement — 5 — Nordic Naturals Omega-3 Fish Oil: https://amzn.to/48q1j2V
Supplement — 6 — Nordic Naturals Kids Vitamin D3 Gummies (Ages 3+): https://amzn.to/4l7117a
Supplement — 7 — Pectasol Modified Citrus Pectin, Formulated in the USA: https://amzn.to/3QUmZfN
Supplement — 8 — Pendulum Metabolic Daily Dietary Supplement: https://amzn.to/4gY5wOm
Cosmetic — 1 — Kora Organics Noni Face Oil: https://amzn.to/43hy2XO
NEW! Cosmetic— 2 — Babo Botanicals Sensitive Baby Lotion**: https://amzn.to/3YmKxy1
Toothpaste — 1 — Fluoride-free Orajel Kids Training Toothpaste in Natural Berry Fruity Flavor with Elmo Sesame Street Packaging: https://amzn.to/41wxtrY
Toothpaste — 2 — Fluoride-free Miessence Mint Toothpaste: https://amzn.to/4bJc4PO
Toothpaste — 3 — Dr. Brown’s Fluoride-free Baby Toothpaste in Strawberry Flavor: https://amzn.to/3DCehzZ
Toothpaste — 4 — Pegciz Kids Foam Toothpaste in Watermelon Flavor, Low Flouride (packaging varies, see report): https://amzn.to/3YzP68e
Toothpaste — 5 — Kid’s Spry Fluoride-free Tooth Gel with Xylitol in Original Flavor: https://amzn.to/41GZb4e
NEW! Toothpaste — 6 — Fluoride-free Essential Oxygen BR Certified Organic in Peppermint Flavor**: https://amzn.to/4lARZ2J

**Lab reports pending/ Not yet published as of 4/28/2025

Here’s the link to our landing page featuring all of the third-party lab reports for the foods, supplements, and cosmetic products we have published to date, including those listed above: https://tamararubin.com/2024/05/food-articles/

Stand by for more!

BONUS: Below are SIX additional products that each tested positive for trace (very low levels of) Arsenic — at levels considered safe by all standards (with the limits of detection noted in the lab report for the specific product listed).

Ingredient — Maseca Instant Corn Masa Flour, Product of Mexico (positive for traces of Arsenic): https://amzn.to/4iR8qWN
Infant Formula — Kendamil Goat Toddler Milk, not organic (positive for traces of Arsenic): May be available at Target or through other online retailers of European infant formulas
Fruit Snack — That’s It Apple Cherry Bars, not organic (positive for traces of Arsenic): https://amzn.to/4fHkSWV
Oil — Chosen Foods 100% Pure Avocado oil, organic (postive for traces of Arsenic): https://amzn.to/3BVQYQa
Supplement — Now Sunflower Lecithin, not organic (positive for traces of Arsenic): https://amzn.to/3AFdHzO
Supplement — WishGarden Immune Boost Seasonal Rescue for Pregnancy: https://amzn.to/3Cd940N

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May 3, 2025 — Saturday What I have written below is in response to a question from a Lead Safe Mama community member.