No one likes to talk about poop (or stool), but it seems unavoidable when you have children. Parents often get concerned about their child’s bowel habits–what’s normal and what’s not.
One bowel issue that may pop up is constipation. Constipation is common in people of all ages, even infants and children. If drinking lots of water (fluids) and eating more fiber hasn’t helped with relief of occasional constipation, you may consider an enema or rectal suppository.
A suppository is a small, solid capsule, and an enema is a liquid medication. These rectal laxatives provide immediate relief and are a good alternative for children who can’t take oral medication.
“Rectal medications are given through the anus into the rectum and are a good option for children with occasional constipation who have not responded to other measures,” said Swati Kolpuru, MD, a pediatric gastroenterologist with Banner Children’s. “It helps with immediate relief as it cleanses the lower portion of the colon.”
There are many enema and rectal suppository products available to relieve constipation, but not all products are recommended for infants or children.
Read on to understand what types of rectal medications are safe for children and the steps to safely give your child an enema or rectal suppository.
What types of rectal laxatives can you give children?
There are multiple over-the-counter suppositories and enema products available to treat constipation.
Generally, you can find two forms of rectal laxatives that are specially designed for young children with smaller capsules and applicators:
- Suppository: These bullet-shaped capsules are designed to melt at body temperature within the rectum. They stimulate the bowel muscles in the intestine to prompt a bowel movement quickly.
- Liquid or foam enema: These formulations come in bottles with tiny nozzles. They work by increasing the water content in the intestine to help create a bowel movement.
Contact your child’s health care provider for the correct product and dosage. Do not attempt to make your own home enema solution.
“It’s difficult to know the exact osmolarity (concentration) with home enema solutions which can cause complications like dehydration and electrolyte imbalance,” Dr. Kolpuru said. “Homemade enemas can be safe only if a person uses the appropriate mixture, sterile equipment and under the direction of a physician.”
How to safely give your child a rectal laxative
Prepare yourself by reading the product’s directions. Then, explain to your child what the laxative will feel like. It may make them feel uncomfortable, but it will not hurt them.
Put on calming music or give your child a book or toy to distract them.
For pediatric enemas:
- Wash your hands with soap and warm water.
- Prepare the liquid enema as directed.
- Remove the protective cap from the applicator and hold the bottle upright.
- Have your child lie on their left side with the left leg straight and the right leg bent forward.
- Hold one buttock cheek gently to one side to see the rectum.
- Gently insert the applicator tip into the opening.
- Gently squeeze out the enema liquid.
- When done, keep the bottle compressed as you gently remove it from the rectum.
- Wash your hands again with soap and warm water.
- Your child should remain relaxed in the same position for at least 10 minutes until they have the urge to poop. Your child may find it difficult to hold the liquid in place initially, but they must keep it in for as long as possible.
For suppositories:
- Wash your hands with soap and warm water.
- Unwrap the suppository and hold it with the rounded end close to the rectum.
- Your child should lie on their left side with their knees bent.
- Hold one buttock cheek gently to one side to see the rectum. Use one finger to insert the suppository gently into the opening. It needs to go in about 2 centimeters (far enough so it doesn’t slip out). You can use lubricating gel to make this more comfortable for your child.
- Ask your child to clench their buttocks together for a few minutes, or you may need to hold them together. This allows your child’s body heat to melt the suppository and deliver the medicine.
- Wash your hands again with soap and warm water.
- It may take 10 to 45 minutes for the medicine to work, so staying close to a toilet is best.
Are there any side effects I should know about?
“Most suppositories and enemas sold over the counter are safe when used as directed and do not cause serious side effects,” Dr. Kolpuru said. “Generally, the only adverse effects are diarrhea and stomach cramps.”
Contact your doctor for medical advice in the following scenarios:
- The rectal laxative does not produce a bowel movement.
- You notice rectal bleeding.
- Your child is nauseous and vomiting.
- Your child has severe stomach pain and stomach bloating.
Takeaway
Constipation can occur to everyone, even children. Rectal laxatives designed for young children can safely provide relief but consult your child’s health care provider first on the correct product and dosage.
In addition, make sure your child is getting plenty of fluids and fiber each day to help keep things running smoothly.
Need help treating constipation?
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Schedule an appointment with a pediatrician near you.
