Wilson & Hockenberry: Wong’s Clinical Manual of Pediatric Nursing, 8th Edition

Patient Teaching Guide

This section may be photocopied and distributed to families.

Giving an Enema

An enema * is needed when stool must be removed from the bowel or intestine. However, simple constipation in children should not be treated with enemas but with changes in the child’s diet. Increasing the amount of liquids to at least 1 quart each day and the amount of fiber in foods (especially whole grains, bran cereals, fresh vegetables, and fruit with the skin on) should increase the size and number of the child’s bowel movements.

Large amounts of milk, rice, bananas, and cheese can cause constipation. The child should eat small amounts of these items. If your child is an infant, ask your health professional before changing the feedings.

If the child has persistent constipation, a complete medical evaluation is necessary to determine the cause. If you have been told by a health professional to give an enema (usually only one or two enemas in a day) to the child, use these instructions.

Age	Amount of Lukewarm Water	Approximate Amount of Salt	Distance to Insert Tube
Infant	cup (120-240 ml, or 4-8 oz)	tsp (1.25-2.5 ml)	1 inch (2.5 cm)
2-4 yr	cups (240-360 ml, or 8-12 oz)	tsp (2.5-3.75 ml)	2 inch (5.0 cm)
4-10 yr	cups (360-480 ml, or 12-16 oz)	tsp (3.75-5.0 ml)	3 inch (7.5 cm)
11 yr	2-3 cups (480-720 ml, or 16-24 oz)	tsp (5.0-7.5 ml)	4 inch (10 cm)