Enema: How to Give

An enema may be prescribed by your child's health care provider to help remove impacted bowel movements (BMs) caused by constipation or other problems. An enema is a liquid that is placed in your child's rectum to stimulate the release of hard stools.

Use the enema solution recommended by your health care provider. The amount of solution you give your child depends on the child's age or weight.

Phosphate solution

Sodium phosphate solution is used in Fleet's enemas. These enemas can be bought at pharmacies without a prescription. Often the pharmacy will also carry a store-brand enema containing the same ingredient. The advantage of phosphate enemas is they come in a disposable squeeze bag with a soft-tipped nozzle. You won't need any other equipment.

If your health care provider recommends giving a phosphate enema, give 1 ounce for every 20 pounds of your child's weight. Don't give any child more than 4.5 ounces of the enema. Caution: Don't give these enemas to children less than 1 year old.

For phosphate enemas purchased in your pharmacy, give the following amounts of (based on your child's weight):

20 pounds. . . . . . . . . . . . . . . 1 ounce
40 pounds. . . . . . . . . . . . . . . 2 ounces
60 pounds. . . . . . . . . . . . . . . 3 ounces
80 pounds. . . . . . . . . . . . . . . 4 ounces
90+ pounds . . . . . . . . . . . . . .4.5 ounces

Phosphate enemas come in 2 sizes: children (2.25. oz) and adult (4.5 oz).

Homemade saline solution

To give a homemade enema, you need an enema bag, an enema tube, a lubricant (such as KY Jelly), and distilled water. You can buy these supplies at most pharmacies. Another option is to use a rubber bulb syringe.

You can make a homemade saline solution by adding 2 teaspoons of table salt to a half a litre quart of lukewarm distilled water. Do not use soapsuds, hydrogen peroxide, or tap water in an enema. They can be dangerous.

The amount of normal saline solution that should be given to children at various ages is:

1 year. . . . . . . . . . . . . . . . . . .4 ounces
1 to 3 years . . . . . . . . . . . . . 6 ounces
3 to 6 years . . . . . . . . . . . . . 8 ounces
6 to 12 years. . . . . . . . . . . . 12 ounces
Adolescents and adults. . 16 ounces

• Have your child drink 1 or 2 glasses of water before the enema. Sometimes enemas can cause dehydration.
• Have your child lie on his stomach with his knees pulled under him.
• Lubricate the enema tube or nozzle and gently put it 1 and 1/2 inches to 2 inches into the rectum.
• If you are giving a disposable enema, gradually squeeze the contents of the bag into the rectum. If you are giving a homemade enema, put the solution into the enema bag. The fluid will flow down gradually by gravity. Keep the enema bag no more than 2 feet above the level of your child's bottom.
• When the bag is empty, remove the tube.
• Your child should wait to go to the bathroom until he feels a strong need to have a bowel movement (in about 2 to 10 minutes).
• If the enema equipment is disposable, throw it away. If it is reusable, clean the tube as best you can with an antibacterial soap and water. Then sterilize it by putting it in boiling water for 10 minutes. The enema bag just needs to be rinsed with water.

	BOWEL Intestine. Consists of the small and large intestines.

	SODIUM An element found in salt and other foods. Sodium helps control the body's water balance.

	PRESCRIPTION A written instruction telling a pharmacist how a medication needs to be prepared, dosed and administered.

	SYRINGE A device used to inject or take out fluid from the body or a body cavity.

	SALINE Salt water.