From the Research
Enemas are not recommended as a first-line treatment for infant constipation, and when necessary, a small-volume saline enema is preferred under direct medical supervision. The use of enemas in infants should be approached with caution due to the risk of disrupting electrolyte balance, damaging rectal tissue, or creating dependence 1. Instead, parents should try gentler approaches such as:
- Increased fluid intake, particularly water for infants over 6 months
- Dietary changes like adding high-fiber foods for older infants who have started solids
- Gentle belly massage If these methods fail, a glycerin suppository (not an enema) may be used occasionally under pediatric guidance 2.
For persistent cases, a pediatrician might recommend a small-volume saline enema, but this should only be administered under direct medical supervision 3. The optimal enema composition and volume may vary depending on the individual case, but higher volume saline flushes used once a day was found to be the optimal solution in one study 3. It is essential to note that enemas can cause serious adverse events, such as perforation or metabolic derangement, especially in the elderly or in patients with underlying medical conditions 1.
Therefore, it is crucial to follow guidelines for the treatment of acute constipation and for enema administration to minimize the risk of adverse events 1. Parents should always consult with their pediatrician before attempting any treatment for infant constipation, especially something as invasive as an enema.