Treating Kids’ Constipation: Should We Use Antifreeze or Molasses?

What if the go-to laxative we give to constipated children was essentially repurposed antifreeze that could secretly sabotage their gut health when a natural, safer alternative like molasses may work even better?

Constipation is a common childhood complaint, affecting up to 30% of children.[1] Often, the problem is as simple as a dietary intolerance to gluten-containing grains or cow's milk, or intestinal dysbiosis  caused by the use of conventional antibiotics (or over 40 other identified contributing causes), but the conventonal medical approach relies far too heavily on symptom suppression and instead of identifying and resolving the root causes, to the detriment of the patient. 

Case in point, pediatricians often turn to osmotic laxatives like polyethylene glycol (PEG) to relieve symptoms. However, emerging research suggests more natural approaches like black strap molasses (BSM) may be just as effective, without the worrisome toxicity of chemically-based approaches like PEG. Moreover, PEG has a wide range of known and unknown side effects and issues with toxicity, whereas molassess has a wide range of side benefits. Clearly, then, the latter is preferrable when it comes to the especially delicate health of infants, toddlers, and children. 

PEG: Repurposed Antifreeze for Babies? 

Polyethylene glycol (PEG) is a petroleum-based compound used commercially as antifreeze and a solvent.[2] Chemically speaking, it is closely related to antifreeze - yet it has become a first-line pharmacological treatment for childhood constipation.[3] By drawing water into the intestines, PEG suppresses symptoms but does not treat underlying intestinal inflammation or dysbiosis.

The most common brand is Miralax produced by Bayer and constitutes about 1/3rd of all laxatives old, annually, in the US, according to Statisa. 

Animal studies show regular PEG consumption is associated with cellular damage and necrosis in intestinal tissues.[4] Its antifreeze properties can also disrupt cellular membranes in the body over time. Thus, the long-term use of PEG laxatives in babies and children gives pause. We simply do not know the effects of chronically altering intestinal permeability and repeatedly exposing delicate guts to this industrial chemical. There may be better, safer ways to treat kids’ constipation.

Black Strap Molasses: Sweet, Nutritious Relief  

Whereas PEG is an artificial petrochemical, black strap molasses (BSM) is an all-natural remedy made from nutrient-dense sugarcane.[5] Rich in essential minerals like iron, calcium, magnesium and potassium, BSM has been used historically as a wholesome treatment for constipation.[6]

Websites like EarthClinic.com contain a wide range of anecdotal reports of health benefits associated with its use, but only recently has molasses been investigated using modern clinical study validation methods. 

A recent double-blinded study compared PEG to BSM syrup for pediatric constipation. It found similar improvement in symptoms over 4 weeks, with no significant differences in efficacy.[7] Yet unlike PEG, BSM treatment showed no adverse effects. Researchers concluded it is a “safe and effective herbal remedy” for kids’ constipation.

The details of the study are summarized as follows:  92 children aged 4-12 years with chronic functional constipation were randomly divided into a BSM syrup group (n=45) and a PEG syrup group (n=47). Both syrups were given at 1 mL/kg body weight per day for 1 month. Symptoms were evaluated at baseline, 2 weeks, and 4 weeks using the ROM III Constipation Measurement Questionnaire. Defecation frequency, stool consistency, soiling, etc. were assessed. Both BSM syrup and PEG syrup significantly improved symptoms of constipation from baseline over the 4 weeks. No significant differences were found between the syrups' efficacy. At 4 weeks, 93.3% of the PEG group and 85.4% of the BSM group were excluded from the diagnostic criteria for functional constipation. BSM syrup was well tolerated with no significant side effects.   The study concluded that BSM syrup is a safe and effective herbal remedy for treating pediatric functional constipation, with efficacy comparable to the standard treatment of PEG syrup.

The mineral and phytonutrient content of BSM likely contributes to its laxative effect. Potassium helps regulate fluids in the gut, while magnesium draws water into the colon to soften stools.[8] Polyphenols reduce intestinal inflammation that can underlie chronic constipation.[9] PEG has no nutritional value or anti-inflammatory activity - it simply forces excess water into the colon through an osmotic effect. In fact, it is possible that PEG has pro-inflammatory and nutrient-depleting effect due to its adverse influence on the intestinal villi of those exposed to it. 

Providing nutrition while relieving constipation symptoms, BSM offers the best of both worlds. This time-tested natural remedy treats the root causes of pediatric constipation without exposing children’s intestines to caustic synthetic chemicals.  

In conclusion, parents and pediatricians would do well to consider black strap molasses as an alternative to polyethylene glycol laxatives. Sometimes older is better - opting for BSM over “repurposed antifreeze” may be a wiser, safer choice for kids’ developing guts.

For more information on the causes and natural solutions for constipation, consult the Greenmedinfo.com database on the topic which contains research on 60 substances of potential therapeutic value, as well as 14 alternative healing modalities which may help. 

References

1. Van den Berg, M.M., Benninga, M.A., Di Lorenzo, C., “Epidemiology of Childhood Constipation: A Systematic Review,” American Journal of Gastroenterology 101, no. 10 (October 2006): 2401-2409, https://doi.org/10.1111/j.1572-0241.2006.00771.x.

2. Baumann, Amy, “Polyethylene Glycol,” Chemical & Engineering News 92, no. 3 (January 20, 2014): 32, https://cen.acs.org/articles/92/i3/Polyethylene-Glycol.html.

3.Philichi, Linda, “Management of Childhood Functional Constipation,” Journal of Pediatric Health Care 32, no. 1 (January-February 2018): 103-111, https://doi.org/10.1016/j.pedhc.2017.09.001.

4. Tomaszewska, Ewa et al., “The Influence of Chronic Administration of PEG-400 on Rat Mucosal Morphology: Histological Examinations,” Folia Medica Cracoviensia 44, no. 1-2 (2003): 115-120.

5. Dehghani, Seyed Mohsen et al., “A Randomized Controlled Double Blinded Trial to Evaluate Efficacy of Oral Administration of Black Strap Molasses (Sugarcane Extract) in Comparison with Polyethylene Glycol on Pediatric Functional Constipation,” Journal of Ethnopharmacology 238 (April 2019): 111845, https://doi.org/10.1016/j.jep.2019.111845.

6. Aghili Shirazi, Mohammad Hossein, Makhzan-al-Adwia [The Storehouse of Medicaments] (Iran University of Medical Sciences, 2009).

7. Yasuda, Gen et al., “Prevalence of Constipation in Continuous Ambulatory Peritoneal Dialysis Patients and Comparison with Hemodialysis Patients,” American Journal of Kidney Diseases 39, no. 6 (June 2002): 1292-1299, https://doi.org/10.1053/ajkd.2002.33377.

8.Nagle, Dale G. et al., “Effect of the Sequestrant Polyethylene Glycol on Cellular ROS Levels and cisplatin Sensitivity in Human Ovarian Cancer,” Cancer Chemotherapy and Pharmacology 63, no. 6 (June 2009): 981–988, https://doi.org/10.1007/s00280-008-0849-5.

9. Dehghani et al., “A Randomized Controlled Double Blinded Trial.”