Health Topics

1. A clean enema bag with tubing (purchase at any pharmacy)
2. Water soluble lubricant
3. Thick towel
4. Small measuring container
5. All enema ingredients as ordered by your health care provider

• Explain to your child why you are giving the enema. You may tell an older child he may feel like he has to go to the bathroom while the solution is flowing in. If this happens, have the child take deep breaths and breathe out through his mouth to help relieve this feeling.
• Place a towel on the bed or floor under your child's hips. If possible, administer the enema on a tiled floor rather than a carpeted floor.
• Have the child lie on his left side with right leg flexed toward his chest.

1. Clamp the tubing to prevent liquid from escaping. Remove cap from tip.
2. Lubricate the tip of the rectal tube.
3. Pour the exact amount of solution as ordered by your health care provider into the bag.
4. Unclamp the tubing and allow a small amount of the solution to run into a measuring container.
5. Test the temperature of the solution by dripping a few drops on your wrist. It should feel warm, not hot.
6. Clamp the tubing and gently put the open end of the tubing into your child's rectum (infants = 1 - 1.5 inches; an older child = 2 – 3 inches; no more than 4 inches) at an angle pointing towards the navel. If there is any resistance when inserting the tip or the solution, carefully withdraw the tip and try a different angle. If you continue to have difficulty, discontinue the procedure and call your doctor.
7. Hold the enema bag about 12 - 15 inches above the child's hips. Allow solution to run into the rectum slowly (about 100 ml/min). If the solution starts to run out of the rectum, briefly squeeze the child's buttocks firmly together around the tube.
8. If cramping occurs (an older child may tell you it hurts and an infant will draw up his knees, and his cry will be higher pitched) shut off the flow of solution for a few seconds by pinching the tubing together, then restart the enema once the child is comfortable again.
9. When all the solution has run in, clamp the tubing and remove it from the child's rectum.
10. Ask your child to remain in the same position until the urge to have a bowel movement is strong (usually within 2 - 5 minutes).

Have your child sit on the toilet or potty chair to release the solution. Check what type of bowel movement he had (hard, formed or runny) and the amount of solution released.

Most of the enema solution should be released.

• the enema did not produce a bowel movement
• the child has pain that does not stop once the enema is done
• there is blood in the bowel movement
• the child continues to have large volume, liquid stool after the enema
• the child has episodes of vomiting, changes in level of alertness or seizures