External Applications in Anthroposophic Nursing

Enema for Children

Guiding principle for the application

Every enema is an intimate nursing procedure. Very sensitive handling of this application is required. An enema can be perceived as unpleasant, since with older children, for instance, a feeling of shame may be involved.
“The aim of the enema, which, if carried out correctly, is absorbed to a considerable extent, is a rapid intake of fluid, through which the patient’s circulation and drinking behavior is stabilized and feelings of weakness and nausea are counteracted. At the same time, mild fever reduction is achieved; the enema has a calming effect and promotes sleep. A resulting emptying of the lower sections of the colon has a relieving effect on the immune system. The implementation of this measure is particularly important for infants with high fever and poor drinking habits. This simple and very effective measure makes some hospital admissions superfluous! (Soldner, Stellmann, 2018, 5th edition, p. 265).

Guiding Principle for the substance

Indications

For children:

  • Febrile states
  • Dehydration
  • Vomiting and diarrhea with dehydration
  • Infectious diseases, viral and bacterial
  • Obstipation
  • Bowel habits

Instructions

Particularities:
Be aware of chamomile intolerance

Materials:

  • Rubber enema, depending on the age of the child (available in 3 sizes at the pharmacy)
  • For older children an irrigator with a tube system
  • Or a bladder syringe with a female catheter size 12 Ch
  • Warm water or thin warm chamomile tea, freshly prepared (approx. 35–37°C (95°F–98.6°F)), to which you add a pinch of pure table salt (roughly equivalent to a physiological saline solution)
  • Quantity of liquid according to age: 50–150 ml
  • Vaseline, to make the attachment easily slidable
  • Bed protection and cellulose and/or kitchen paper
  • Diaper or incontinence pad
  • Blanket to cover the child


Instructions:
  • Prepare bed protection und incontinence pad
  • Fill the rubber enema/irrigator
  • Grease the attachment piece
  • The child lies on his or her left side, with legs bent
  • Allow the liquid to run to the base of the catheter (the tube is empty of air)
  • Gently insert the end of the catheter or the attachment piece into the anus
  • Let the liquid slowly into the intestine (if using an irrigator: regulate the intake speed by the height of the irrigator)
  • Withdraw the catheter, clamped, and grasp the attachment with the paper towel
  • Put a diaper on the child, covering him or her comfortably and warmly
  • Observe the condition of the child, stay nearby
  • A repetition is possible after 1–2 hours


Follow-up:
  • Thoroughly clean the rubber enema
  • Dispose of disposable material

Evidence
Well-proven in many patients
Dosage
1–3 x daily
Onset of effect
Immediate
Length of therapy
Until the child drinks itself again within one day
Warning
If the child does not drink for more than 1 day, consultation with a doctor is urgently required!

Case example

A 3-year-old boy suddenly has a high fever of over 39.5°C (103.1°F) with a febrile convulsion. The family doctor recommends an enema. The mother gives the child 100 ml chamomile tea as an enema after the fever cramp. 5 minutes after the enema, the child empties stool and a glass marble. The child sits up and his body temperature returns to normal within 15 minutes. The mother had not known about the swallowed glass marble.
TB

Author

TB, Red.

Bibliography

Soldner G, Stellmann HM. Individuelle Pädiatrie. Leibliche, seelische und geistige Aspekte in Diagnostik und Beratung. Anthroposophisch-homöopathische Therapie. 5th edition Stuttgart: Wissenschaftliche Verlagsgesellschaft; 2018. English translation: Soldner G, Stellmann HM. Individual paediatrics. Physical, emotional and spiritual aspects of diagnosis and counseling. Stuttgart: Wissenschaftliche Verlagsgesellschaft; 2014.