Appropriate PEG Dosing for a 6-Year-Old Child
For a 6-year-old child, the appropriate dose of Polyethylene Glycol (PEG) is 0.5-0.8 g/kg/day, which typically equals about 10-17 grams per day for constipation management.
Dosing Guidelines
PEG (also known as Miralax, GlycoLax, or other brand names) is commonly used for treating constipation in children. The dosing should be based on the child's weight rather than age alone:
- Initial dosing: 0.5-0.8 g/kg/day 1
- For a typical 6-year-old (weighing approximately 20-22 kg):
- This translates to approximately 10-17 grams of PEG per day
- Can be mixed in 4-8 ounces of water or juice
- Should be administered once daily
Evidence-Based Dosing
Research supports these dosing recommendations:
- Studies show that a dose of around 0.5 g/kg/day is effective in more than 90% of constipated children aged 6 months to 15 years 1
- For more severe constipation or fecal impaction, higher doses of 1-1.5 g/kg/day for 3 days have been shown to be more effective (95% success rate vs. 55% at lower doses) 2
- For infants and very young children, a lower maintenance dose of 0.78 g/kg/day has been found safe and effective 3
Administration Tips
- Mix the powder completely in liquid until dissolved
- Can be given with or without food
- Best administered in the morning to establish a regular bowel routine
- Full effect may take 24-48 hours to develop
- Maintain adequate hydration while using PEG
Monitoring and Adjustments
- If stools become too loose, decrease the dose by 25%
- If constipation persists after 2-3 days, the dose can be increased
- Monitor for side effects, which may include:
- Bloating (18% of children)
- Diarrhea (13%)
- Nausea (5%)
- Cramping (5%)
- Vomiting (5%) 2
Important Considerations
- PEG works by drawing water into the intestinal lumen, softening stool and increasing bowel movements
- Unlike adult dosing, pediatric dosing must account for the child's size and organ maturity 4, 5
- PEG is generally considered safer than many other laxatives for children as it does not cause significant electrolyte disturbances when used as directed
- For maintenance therapy after initial treatment of constipation, the dose may need to be adjusted based on response
Alternative Options
If PEG is unavailable or not tolerated, alternatives include:
- Glycerin suppositories (1 g/kg up to maximum of 50g per dose) 6
- Normal saline enemas (10 mL/kg) for acute management 6
Remember that treating the underlying causes of constipation (dietary changes, increased fluid intake, regular toilet habits) should accompany medication management for best results.