Should I give my 4 year old an enema?

My 4 year old got constipated a few months ago. After such a large stool, she started crossing her legs to keep from having a bm. I took her to the doc and he said it was a behavioral problem and not a physical one and that she was not chronically constipated, but if we let her continue to withold, she would become that way. He put her on mirilax for 6 months. He said we would have to make her go regardless of what she wanted until her behavior changed. I took her back to the same clinic for a regular exam and was seen by a nurse practitioner. She told me my daughter was chronically constipated or the doc wouldn't have put her on mirilax for 6 months. I explained the situation as the doctor had, but she continued to insist my child was chronically constipated. She then felt my childs abdomen and told me that my child needed an enema. My daughter had a bm the day before that was soft and another after the clinic visit that was soft and one today that was soft. (went to clinic yesterday

Skip the enema. They're scary for little kids. Your child is prime age for what I call conscious constipation. If they have one big painful BM, they hold it because they're scared it's going to hurt again.
Try this: put her in a warm bathtub with 2 ounces of baking soda in the tub. Give her some tub toys and let her play for up to 30 minutes. The warm water will make her relax and go. If she goes in the tub, it's not a big deal. That's why Clorox was created! =) I told this to a mom of a stubborn 2 year old, and she said after 10 minutes, he got out and sat on the toilet to go.

Otherwise, glycerine suppositories will stimulate her to go and smooth the way a little.

I do agree with the establishing a habit of going - have her sit on the toilet the same time each day for a few minutes - even if she says she doesn't have to go. She might get surprised.

no that will be traumatic... maybe colace is a solution... an enema is a little drastic. if there is truly a blockage , then the blockage has to be surgically removed, but i dont know what the doctor felt.

If she had a BM the day before, and a BM today, and both were soft, I'd hold off on an enema.

It is possible that in the upper part of the lower intestine, she has impacted fecal matter, which the nurse felt. But, wait 2 or so more days and see if she has more BM's. If she starts having abdominal pains, then take her to the Doc and get that enema.

I would talk to your doctor. As helpful as nurse practioners are they are not doctors. Call your doctor before you give your child an enema and explain to him what the nurse practioner told you.

NO !

No, do not give your daughter an enema. For whatever reason she is scared of having a bm. Find out why. Some kids still want to do their BM's in a diaper, my friend's daughter does and she's potty-trained. Just feed her healthy foods with enough fiber, I'm not sure what the recommended daily allowance of fiber is for a 4 year old, but it's probably somewhere on the Internet. Try not to give her medicine too often or her body will become reliant on it and that will be the only way she can have a BM. Make sure she is drinking enough water throughout the day, and about 6 ounces of apple juice each day should help. Good Luck.

I feel your pain. Had similar trouble with my seven year old. I don't know anything about that mirilax, but can tell you that the only thing that has helped is eating LOTS of fiber. I buy fibersure and add it to all her drinks, I make bran muffins and other baked things and add fibersure, and we all eat whole grain bread (they make white now, and it has 4 grams of fiber per serving -- made by Wonder). The fibersure is tastless -- she hasn't been able to detect it in anything yet. Try adding fiber. Now, about that enema, I tried a baby fleet enema and it didn't do much at all. It removed whatever waste was right there, but nothing much from further on up, I don't think. She hated it, I hated it, and I really don't think it was a good idea unless as a last resort. Good luck! Give her fiber at every meal, and this, too, shall pass!

NO WAY!!! That could be a very traumatic time for your daughter. How about trying an alternative to chemicals, try and get her to drink lots and lots of natural pear juice. Because of all of the fibre in pears, the fibre is what makes you go. And here's a little saying that may help ease the tension, If you don't eat, you don't sh*t and if you don't sh*t you die.

You know your daughter better than anyone else. If she is not chronically constipated, I would not give her an enema, no matter WHAT the nurse practitioner said. You heard what the doctor said, not her, and her unwillingness to listen to you is her flaw, not yours.
I would think that giving her an enema would traumatize her more, not make her feel better.
You have the right, as her mother, to listen to the advice, and take away from it what will work for you. If what the nurse said isn't going to work, then I would just ignore it, and trust your judgement.

I've always heard that constipation can be controlled through diet. There are some hints about dealing with children's constipation at: http://pediatrics.about.com/cs/condition...

you need a new doctor. Geez.. your kid is constipated and trying to stop a bm because it hurts like heck and he is saying she has behaviourss for trying to hold her poop in... that is not cool...

and an enema.. 'no' no no... give her bran, that is what I take.. also lactose in non addictive and works well when taken consistenly... etc. Worst case senerio adn only very rarely could be a suppositoy.. but they can be addictive... for my kid I would use bran first.. sprinkle it on cereal... mix it in jam and put it on toast..

Prunes and stuff are great.. but I don't know anyone that like s them

Boy how I remember thoes days when my daughter use to get that way.My daughter use to eat lint and the little fuzzys on blankets so it would make her backed up.Email me and I will tell you what I did because I dont want a bunch of ewws from people
on this site

She does not need an enema. If she is have regular, soft BM's then she is fine. If she does not go for 3 or more days, consider an enema.

An enema at this point is not a solution. There is not a problem is she has had consistent, soft-formed (not runny) stools. She has had a stool today, and has had consistent stools for the last 3 days. (Sounds like the nurse practitioner didn't know what she was talking about.)
You should only be concerned if she misses 3 or 4 days and starts to act like her stomach or bottom hurts. One formed or soft stool a day or even every 3 days is enough. (Every child is different, though, and you should take her schedule into consideration. My own daughter sometimes takes 3 to 4 days to have a normal stool and has been this way since birth.)
You should not be concerned right now. Feed her lots of fruit and bran, and keep a written record of her BMs. If you become concerned, take her back to the clinic. Insist that you see the doctor that prescribed the mirilax, and no one else.
Abdominal pain due to intestinal blockage cannot be fixed at home, and if you cannot see her doctor right away, take her to another doctor, or, as a last resort, to the ER.
If you can't see him for a few days, and your daughter is in pain (in her bottom, not her abdomen), a simple, small, warm water enema given with a KY-lubircated nose syringe should relieve her. Do not give her an over-the-counter enema with any kind of soap or medicine in it, because you don't know how that could harm her.
I think she's just fine and the NP was full of it, but you are your daughter's mother. Keep an eye on her, and don't make an issue out of a non-issue. I'm sure you'll make the right decision.

If you feel it is not needed no. Go and see the doctor, not the nurse.

I wouldn't. Perhaps you could try to get another appt. and demand to see the same doctor this time.

My 4 year old was the same way! He would not go for days and had a large BM and was afraid to go again. For us it was potty training that threw him into "boycotting" using the toilet and he'd hold it. We did use an enema...NEVER again! It was horrible for all of us. He got little spurts of diarrhea for hours and we changed his pants so many times. His stomach was so sore and he finally "went" and it was over but very hard on us. Now when he gets irregular I use Little Tummy's Natural Vegetable Laxative. Its chocolate flavor and works over night like a dream and no pain or tummy aches at all.

I don't think an enema is necessary.
If you think she is constipated, i'd give her straight Orange Juice .. and more water.