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Salt water enemas are effective in relieving constipation, are easy to mix, and can be administered by the parent or caregiver.
Dissolve 1 teaspoon of table salt in 1 liter (1000 cc) of water to make the correct concentration. The enema is then delivered through a soft rubber tube that can be inserted easily into the child's rectum (approximately 4 inches). Your child's physician will decide what volume of fluid should be delivered.
To deliver the enema, the child should be placed on their side or stomach with the knees pulled up under the chest with their bottom in the air. These two positions are most effective for giving enemas because they allow the fluid to be instilled easily into the colon.
Once the catheter is inserted, the balloon at the end of the catheter must be inflated. Usually, 20 to 25cc of water is used to inflate the balloon once the catheter is in the rectum. This forms a "plug" and prevents the enema fluid from leaking out of the child's bottom. Once the fluid has been given, the child should remain in the "enema position" for 5 minutes. This can be difficult for young patients, but keeping the child in the enema position will help to retain the fluid as long as possible. It is recommended that a timer be used so the time for the enema to absorb is constant every day.
After several minutes of enema retention, have the child sit on the toilet for approximately 45 minutes to allow complete evacuation. This experience can be made more pleasant by having books, art supplies or videos available. If the child is in diapers, simply diaper the child and wait for the results.
Enemas should be given at approximately the same time each day. This helps train the bowel to be emptied on a regular schedule.
Your doctor will give you specific guidelines for your child's enema. Sometimes it is necessary to add phosphate or glycerin to the enema solution to produce a satisfactory bowel movement.