Parents rarely talk to each other about their experiences giving their children enemas. It's understandable, but it's also unfortunate as there is a lot to be learned, especially when considering giving one for the first time. I asked a parent I have been working with if she'd be willing to write a little about her experiences giving her 3 year old son enemas and she agreed. Below is her story:
I recently spoke with Dr. Tom and he asked me to write about our experience with enemas. I was initially reluctant to do them. I've never had one myself and giving them to a 3 year old seemed daunting. Prior to using enemas, we went for months using Miralax, trying to come up with a strategy to get him to move toward the potty when he was about to poop.
If his bottom was naked, he would actually run and poop in the potty. But if I put him in underwear, a pull up, or just pants on him, he would poop wherever he was when he felt the urge and none of my strategies got him to budge. So I finally decided to try an enema. I figured that with an enema I could control when and where he would get the urge and so that when it came I could immediately start moving him toward the bathroom.
We talked about it a lot before doing the first one. We practiced in front of the television with a towel to lie on and a pillow. We explained how we would put the "water medicine" in his bottom and then put his pull up back on. We told him that he could keep watching TV until he felt poop trying to come out. But that as soon as he felt poop coming, we wanted him to run into the dining room before he pooped. Up until this point in the conversation, he'd been agreeable or only mildly reluctant about everything, but he flat out said, “No” to the request to go into the dining room before he pooped. I then told him that if he pooped in the dining room he would get a toy car. He brightened up. "Okay!" I consider that moment the turning point in our efforts.
Initially, getting him into position and then accepting the enema took some time. I used the television as immediate positive feedback for getting closer to the right position (he'd get maybe 20-30 seconds of his show for each tiny step in the right direction) and for allowing me to get the enema into him. He pooped in the dining room that morning, in the kitchen the next day and in the bathroom the next morning.
Transitioning to pooping in the potty took a few more days. I eventually figured out that I had to do two things: I had to be in the bathroom when he pooped and I had to make it easy to get the reward he was interested in. So, as soon as we did the enema and put his pull up back on, I went into the bathroom. He was told that he could get one toy for pooping in the bathroom or two toys if he pooped in the potty. He chose the potty!
We used enemas daily for several weeks. Getting him off the enemas was actually harder for us than getting him started. We had to increase his Miralax dosage a lot. He would beg me for "water medicine" and had several accidents during the transition. But as soon we found the right dosage he started pooping in the potty spontaneously.
Unfortunately, after a few months, he started withholding again so we had to restart the Miralax and the enemas. The return to withholding made everyone unhappy, including him. He remembered what it was like to be able to go when he felt the urge and was clearly frustrated. Right now, he gets one toy for pooping with an enema or two for pooping without one. We've recently gotten a couple of spontaneous poops in the potty but most days require an enema. We'd all love to be done with them, but I expect it will happen on his timeframe and no sooner.
Thanks so much to this parent for such a well-written and detailed description. My book also features a chapter on enemas, including other ideas on how to allow your child some control in what can otherwise be an uncomfortable situation.