Well this is an interesting one as there are a few different factors which need to be considered. For the purposes of this article I am speaking about the use of suppositories to treat fever and pain, and not referring to their use in constipation. For more information on constipation and how it can be treated effectively click here.
The first thing I have to say is that suppositories are not as scary as some people think, they are just cone-shaped boluses of medicine which can be easily given to your child to treat pain of fever when a liquid is not suitable. Suppositories available to treat fever and pain include ones based on paracetamol such as Paralink and Tipol, and ones based on ibuprofen such as nurofen. These are both suitable from three months of age – just make sure to read the packaging to get the correct dosing for your child.
Before I go into the detail of how you actually use suppositories I’m going to get straight to the point and tell you when you SHOULD use suppositories.
- Use them if your child has a high fever or is in pain and will not or cannot take oral medication.
- Use them to treat fever or pain when your child has vomiting.
- My mummy perspective suggests using them when you are travelling to avoid having to carry lots of liquids.. I suggest this only for young children who are quite happy to use a suppository over oral meds.
What are the pros and cons?
Using suppositories is more invasive than using oral medicine so a correct approach and a respect for your child’s comfort is essential. I will explain in the next section how to use them but now I just want to emphasise that when used properly with a willing child they are so simple, easy and convenient to use. I personally feel that a child who is still in nappies is an ideal candidate for this method of giving medicine – they are used to you cleaning and touching their nappy area and so will not be distressed when you insert the suppository – in fact many children will not even notice!! I also think it is a different situation when a child is out of nappies and unless you have the child’s permission and general understanding of what is going to happen I think the oral route of medicine is best when possible. Another factor to consider is that suppositories have been proven effective for the treatment of pain or fever but they may actually take a little longer to take effect than oral medicine.
When faced with a vomiting child with a high temperature that needs to come down, or a child with a jaw so tightly clenched and unwilling to take oral medicine it is definitely a good idea to have suppositories on stand by.
So how to you use them?
For this bit I’m going to cheat and provide you with a perfect explanation from the Great Ormond Street Children’s Hospital in London:
“Remember – suppositories should never be swallowed.
- Sit your child on the toilet to see if they need a poo.
- Wash your hands.
- Warm the suppository in your hands for a minute.
- Remove the foil or plastic wrapping.
- Get your child into any of these positions to give the suppository:
- squatting down
- lying on one side with one leg straight and the other bent
- standing up with one leg raised
- Gently but firmly push the suppository into your child’s bottom as instructed.
- Push it in far enough that it does not slip out again.
- Ask your child to close their legs and hold your child’s buttocks together for a few minutes.
- Wash your hands again.
If your child needs a second suppository, wait until the first has dissolved before inserting the second.”
I will add that for younger children such as babies in nappies I would advise that you place them on their backs and proceed to change their nappy – when you have the dirty nappy off and area wiped clean I would hold their legs back gently towards them with their knees bent and insert the suppository then and continue with the nappy change as normal.
Some Useful Hints
- If the suppository is warm before you open it you can run the wrapper under a cold tap or place it in a fridge for a few minutes to cool it as it can not be inserted when melted.
- Being calm and confident will help your child to feel calm and confident in your actions.
- If your child will take oral medicine and finds the use of suppositories distressing then do not persist – just offer oral medicine when necessary.
- If you would like some tips on how to give your child oral medication then just click here!
- Having a book ready so that you can scoop your child into your arms and settle them on your knee to read a story which will help them sit still to allow the suppository to absorb.
- You should always consider the psychological welfare of your child and explain everything that you are doing – I even do it with babies even though they may have no idea what I’m talking about so that they get used to you respecting their personal space from an early age.
- Sometimes the advice I have to give can make the process sound scarier than it really is – I assure you – babies in nappies most often are quite happy for you to administer a suppository and it can be such a great means to reduce a temperature that you may otherwise struggle to.
Who should not use suppositories?
- Children who have had bowel surgery unless prescribed by a doctor
- Children who have an oncological condition or are otherwise immunocompromised.
- Children who have irritable bowel disease.
I hope you found this information helpful and as always don’t hesitate to contact me on the WonderBaba Facebook page (https://www.facebook.com/wonderbabacare) with any questions or for one to one advice for your little one! You can also consult with me in person at Milltown totalhealth Pharmacy in Dublin 6 or over the phone on 012600262.
- Paralink SPC
- Nurofen for Children SPC
- Royal College of Nursing (RCN publication 002 062) (2003) Digital rectal examination: guidance for nurses working with children and young people. Viewed on: 09/12/2014.