I think most of us believe the days of medical professionals recommending enemas for children were over years ago. Yes, there are some colonic clinics and alternative medical practionrrs that still suggest them, but you might find this interesting.
https://www.bedwettingandaccidents.com/single-post/2015/06/24/Introducing-MOP-The-Very-Best-Way-to-Resolve-Bedwetting-and-Accidents
Parents ask me all the time: How can I get my child on board with enemas? She’s terrified.
In this post I offer 11 practical ideas, most of them suggested by parents who’ve been through M.O.P. (the Modified O’Regan Protocol), the most effective — but least fun — way to resolve bedwetting and accidents. These folks know what they’re talking about!
The best advice from experienced parents: Don’t run the show. Instead, work with your child to find a solution to his fear or discomfort. “For M.O.P. to work, you have to address your child's concerns and engage his cooperation,” one mom posted on our private Facebook support group. “Recognize your child is a partner in this treatment.”
Minor adjustments can make a big difference — a shift in body position, a different enema tip or solution, a new reward or way of explaining why enemas work better than oral medicine. You won’t know what works until you try. The problem may be something you hadn’t even considered. “It turns out my son hated the glove I was wearing to apply the Vaseline to his bottom for extra lubrication,” one mom wrote. “It took a while for us to figure that out.” Now she has ditched the glove, her son considers enemas no big deal.
Yes, no big deal! Parents are often surprised when enemas become routine for their children. Many children on M.O.P. actually request their nightly enemas, because getting cleaned out makes them feel so much better. As one mom emailed: “My daughter’s entire demeanor has changed after 36 days on M.O.P. She’s a happy kid again. . . Now she sings, ‘I just can’t wait for my enema’ to the Lion King song!”
Another mom posted a photo of her 4-year-old son “playing constipation” with his marble run. She wrote: “The commentary was hilarious: ‘Look at all of this hard poop. This colon is clogged. It's constipated! But that's okay, I'll just give it an enema!’”
If your child’s first enema doesn’t go well, team up with your child to figure out why, and give it another shot when he or she is ready. Your kid just might end up being the one who plays “enema” with his marbles in the living room.
Here are some ideas for easing your child’s fear or discomfort.
1. Compare the enema tip to a typical poop. Constipated kids poop out giant logs and jumbo sausages — hard stools that are much wider than a pencil-sized enema tip. Point out the difference! “One trick I use with hesitant kids is to have them show me the average diameter of their stools,” says Erin Wetjen, PT, a Mayo Clinic physical therapist who specializes in pediatric incontinence. “Then I pull out the enema and show them the small tip in comparison to the large circle they make with their hands.” With some perspective, Erin says, enemas don’t seem so scary.
2. Appeal to your child’s inner scientist. Many kids are fascinated by the workings of an enema. One mom, whose son recently switched from M.O.P. to M.O.P.+, says the transition was difficult because a large-volume enema is more awkward to administer than a pediatric enema and requires more of her son’s focus. But she found a solution to his resistance: “We switched to a clear bag, and watching the fluid draining out fascinated him. He has a keen interest in science and anatomy, so that's helped us in working together on the treatment.”
Another mom did a variety of clever demonstrations. “The inspiration came one morning at breakfast,” she wrote. “There was a large, hard lump of sugary flavoring at the bottom of my son's instant oatmeal packet. I told him this is what his poop is like in his colon: hard and dry and hard to break up. I asked him to try to squish it, and he couldn't. I placed it in a bowl, and then poured water over it. While it dissolved, I told him that's what happens when we use the enema.” She has also used a sugar cube and a syringe of water, as well as a soft peppermint and water. “The peppermint worked especially well because it took a few squirts to start getting mushy,” she said. “Now he has a concrete visual for why we are doing M.O.P.”
3. Offer a reward. Screen time, ice cream for breakfast, cold, hard cash — whatever works. I think any child unlucky enough to have to undergo M.O.P. deserves a prize. “We started with Starbursts, and then we moved on to iPhone use, which my daughter seems to love,” one mom wrote. Said another: “My daughter asks every day, ‘Can we do my bum medicine?’ because she gets to watch a show while sitting on the potty.” Another mom reported offering her son $1 for each large-volume enema (part of the M.O.P.+ protocol).
If your child needs more incentive, go for it. One mom throws her son a “super pooper party” after each enema: “He gets a cookie or other small treat with a candle in it. We sing, ‘You're a super pooper’ to the tune of happy birthday. It's ridiculous, but it works. There is also a chart and a big prize after the 30th enema.”
4. Give yourself an enema. Yes, you! What better way to show empathy and offer a scouting report? Children greatly appreciate this gesture, and you will learn from the experience. “The first time went really poorly for my 6-year-old daughter because I was so nervous, and I had no idea what it was like,” one mom wrote. “I had my daughter on the wrong side, and she freaked out, saying it hurt.” The mom stopped and later gave herself an enema. “I understood how insertion is important and that she must be on her left side with knees held tightly into her chest.”
5. Let your child give YOU an enema! I have to admit: I had never considered this idea until a mom posted about it on our Facebook page. After the first enema was painful for her child, this mom wrote: “I asked her if she wanted to give me an enema first, and if it did not hurt, would she be willing to try it again? She is an only child and likes to do what adults do. She said yes. That did it for us!”
6. Plant the idea and give it time to take root. Few kids will respond well to, “Hey, guess what we’re going to do tonight? An enema!” But they may be receptive if you introduce the concept gradually and point out that lots of kids have enemas. “We read Bedwetting and Accidents Aren't Your Fault together before we ever began M.O.P.,” says the mom of an 8-year-old boy. “I had mentioned several times that we might go that route.” When laxatives and high-dose cleanouts did not resolve her son’s encopresis, he was well prepared for enemas.
You never know: With enough exposure to the idea, your child might even ask for enemas! As the mom of a 7-year-old wrote: “My daughter and I read Bedwetting and Accidents Aren’t Your Fault several times when she was just on Miralax, and she suggested trying the enemas herself.”
7. Explain why enemas work better than oral laxatives. Kids in grade school can get the gist of my published study comparing enemas to Miralax: Only 3 out of 10 kids got better on Miralax, but almost 9 out of 10 got better with enemas. Explain that the lump of poop is stuck at the very end of their colon, near where poop exits; Miralax comes from the top down and can’t do as good a job cleaning out the hardened mass at the bottom.
8. Let your child take charge. Taking an active role in the process helps children feel less apprehensive. Wrote one mom: “Our approach was to have our daughter do the insertion herself. So we talked through the sensations, had her "practice" with her own finger first (trimmed nails and clean!).” Children as young as 6 or 7 may be able to insert the enema tip on their own; others may prefer that you do it for them. Ask your child’s preference, and check in often to see if he or she still feels that way.
Children who are too young to insert the enema tip can still take charge, with small acts like opening the packaging themselves. “My 4-year-old really likes taking the cap off and holding the bottle before we do it,” one mom posted. “I think it gives him a sense of control.”
You can maintain this sense of control by narrating the process, step-by-step, and asking for feedback. “I listen carefully to my son as we're doing the enema,” one mom wrote. “I wait to insert the nozzle until he is breathing deeply and is in the correct knees-to-chest position. I apologize if I poke him accidentally. I praise him for participating in every step.”
9. Help your child relax. When your child’s bottom muscles are relaxed, the enema tip will slide in easily, so encourage your child to take deep breaths, like blowing out birthday candles or blowing up a balloon. Holding her hand may help, too. “The first week was rough and my son held my hand while Dad did the enema,” one mom wrote. Now, enemas have become so routine “that he doesn't even notice.” (The screen time he gets no doubt helps!) Another mom wrote: “My 4-year-old wanted big sister to hold her hand.”
Make your child as comfortable as possible. One mom uses a portable heater in the bathroom “to keep it cozy warm.” In addition, her son asks to be brushed prior to the enema, using the Wilbarger brushing technique commonly used in occupational therapy. “Brushing really helps [him relax],” she wrote. We're only five nights in, but after nearly giving up all hope, I'm so pleased with how it's going.”
10. Add lubrication to the tip and/or your child’s bottom. Countless parents have told me that adding KY jelly or Vaseline made all the difference.
11. Experiment with different enemas. If your child is particularly sensitive to phosphate, found in pediatric enemas, you might try liquid glycerin suppositories. They are gentler and have a smaller tip, though they may not be as effective (in which case large-volume saline or glycerin enemas, described in The M.O.P. Book, might work better). Says one mom: “My 8-year-old preferred liquid glycerin suppositories to pediatric enemas because of the smaller nozzle, so I alternated them.”
The parents in our Facebook support group are always coming up with new ideas. As one mom wrote: “Reading what other parents are doing was a game changer — it gave me the confidence to try enemas again.”