Baby suppositories
May 13, 2011 7:25 AM   Subscribe

I need to administer a suppository to a very small baby. Any advice and tricks from people with experience?

I forsee two problems:
1) baby scrunches up her rosetta so hard I can't get anything in (she hates having a naked bum)
2) once in, it stimulates her anus, so she poops it right back at me.
posted by Omnomnom to Health & Fitness (28 answers total)
1. lube
2. push gently
3. hold your finger there for a few minutes til the urge for her to push it out subsides.
4. reinsert as necessary

good luck!
posted by SLC Mom at 7:29 AM on May 13, 2011

Is she constipated? If so, the simple act of inserting it will likely solve the problem and taking a rectal temp might be enough. Most suppositories are gently lubricated and you'll just have to be gentle and persistent.
posted by leslies at 7:30 AM on May 13, 2011

I gotta throw this out here, just in case, as it is a pretty common...misunderstanding. Is this a breastfed baby...?

Some breastfed babies, after the first three to four weeks of life, may suddenly change their stool pattern from many each day, to one every three days or even less. Some babies have gone as long as 20 days or more without a bowel movement. As long as the baby is otherwise well, and the stool is the usual pasty or soft, yellow movement, this is not constipation and is of no concern. No treatment is necessary or desirable, because no treatment is necessary or desirable for something that is normal. via
posted by kmennie at 7:46 AM on May 13, 2011 [2 favorites]

1. heat the room - less scrunching
2. lube, very gentle, and push in from edge closer to genitals (not the other side closer to the back.)

and of course I'm assuming there's some special circumstance that makes you sure it's necessary, since kmennie's right, sometimes they just don't go for days.
posted by fingersandtoes at 8:09 AM on May 13, 2011

Yes it is breastfed and no, it's mostly just normal colicky belly cramps. The doctor, the midwife and several mothers recommended the suppositories so we're giving it a try.
posted by Omnomnom at 8:10 AM on May 13, 2011

We went through this with my son - also an entirely breastfed baby at that point - hence my experience. Colic is no fun - good luck!
posted by leslies at 8:31 AM on May 13, 2011

We had to do this a couple of times, and always found it less stressful if it were a two person job - one to carefully keep baby in place, and the other to do the job at hand.

Lay down lots of towels (lots of towels. Yes, those, and then a few more.)

Try to remain calm and relaxed yourself. Babies are very sensitive to tension in mom/dad.

My Pede always recommended that a BF while my husband inserted the suppository, but I was never brave enough to try that.
posted by anastasiav at 9:05 AM on May 13, 2011

We had much better luck with thermometers when the baby was on his belly, lying across a lap.
posted by wg at 9:07 AM on May 13, 2011

@anastasiav What's a BF in this context? Boyfriend seems unlikely.
posted by curious_yellow at 9:28 AM on May 13, 2011

I'm assuming it was supposed to be "that I BF," which would be "that I breastfeed."
posted by naturalog at 9:34 AM on May 13, 2011

Aha that makes sense.
posted by curious_yellow at 9:43 AM on May 13, 2011

...not really!
posted by Omnomnom at 9:49 AM on May 13, 2011

I grok that I am going against "The doctor, the midwife and several mothers," but you are getting old wives' tales passed off as medical advice. Likely they are more accustomed to formula-fed babies and the digestive hassles of same. There is no good reason at all to do this; your kid is absolutely not constipated.

Totally normal for newborns to kick a fuss and to have digestive oddness while fussing. Doesn't mean they are in pain or that any treatment is needed.

There is lots of stuff sold in the baby section of the drugstore and so little of it is actually needed or useful -- don't fall for the idea that it must be benign just because, well, lots of babies end up with it.

See a lactation consultant, a certified 'IBCLC,' if you want up-to-date advice on handling digestive bothers.
posted by kmennie at 10:08 AM on May 13, 2011 [1 favorite]

As someone who had to do this fairly frequently when her babies were small, I agree with SLC Mom. Raise her legs up high w/one hand and put some of your usual vaseline/diaper cream to lube, then gently push it in with one finger (trim your fingernail first!) and keep it there for about a minute. She'll resist at first, then relax and it will be fine.

I also agree that for constipation, it often works really well to insert a rectal thermometer w/some lube, move it around gently in a few circles, and then quickly put the diaper back on. Actually, it should go w/out saying that quickly putting the diaper back on is critical in both cases!

Honestly, the first time is the hardest and after that you're a pro. She'll be fine!
posted by widdershins at 10:19 AM on May 13, 2011

Kmennie, I know my kid is not constipated. I'm not the one who brought constiPation up and I would prefer it if we could stop discussing constipation as this is not the problem.
posted by Omnomnom at 10:30 AM on May 13, 2011

We did this with our LO and it was way, way easier than anticipated. just lifted legs and plopped it in pronto.They can't fight and don't know to fight it anyway.
posted by kristymcj at 10:35 AM on May 13, 2011

2nding the baby face down over lap or boppie pillow or something technique. Let the legs kinda fall at a 90 degree angle (or you know as close to that as baby legs are when they dangle) and make sure baby is relaxed as you can get her. The position i'm trying to describe is like teh position the baby would be in if you were burping her but then laid oh your back on the floor.
posted by WeekendJen at 10:47 AM on May 13, 2011

I wouldn't give suppository unless there is constipation.

I have been there with an extremely colicky baby. No, I am not exaggerating --- 4 pm - at least 11 or midnight every night, and I tried everything, some of which would work, some of which would not on any given night. Oh, and those books that say colic only lasts about six weeks? My kid took it to 10.

I know colic. So, if colic is the issue, I can recommend a lot of things that may help, but if colic is the issue, it is unlikely that a suppository is going to help any more than anything else and to me, as someone who again had Colic Extreme playing at home, I never even considered that option because, well, suppositories are used explicitly for constipation. They don't assist with much else. For anyone.

And you really do need to be careful because suppositories in tiny beings can cause dehydration. We had to give two to my son, but he was about 11 months old, clearly straining and in pain, and running around upset at 11 at night in our apartment and couldn't get comfortable no matter the position. We had to administer one again a few days later. So we made sure he had extra water or milk to drink. We did it by me holding him over my lap, one hand on his legs, one hand his back, while my husband very, very, very slowly and gently inserted the suppository. And as soon as he squirmed, we took it out. If he didn't get a recommended full dose, we didn't worry about it.

But to go back to the colic, trust me, I have a repertoire of techniques and combination of techniques that I would be more than happy to share with you.
posted by zizzle at 11:07 AM on May 13, 2011

A suppository is a method of giving medication, commonly to promote pooping. If your baby is healthy, I would avoid any medication. I don't know what "colicky belly cramps" means, but belly cramps are not normal for babies. Breastfed babies often have gurgly tummies, but shouldn't need medication. My only recommendation for a suppository is to make sure it's body temp, not cold.

If your baby has colic, I have some information I can send you. There's appallingly little documentation on infant colic.
posted by theora55 at 11:09 AM on May 13, 2011

Sure, I welcome any information about colics. I have tried a variety of things already but would appreciate your PMs. And please keep the info on suppositories coming, too, I appreciate it.
Colics commonly last 3 months and they are extremely common. Ours has all the classic signs of several hours of screaming because of difficulties passing wind and stool. It does pass, but the intestines are still too underequipped to handle digestion easily. Here, colics are generally treated with fenugreek and caraway tea (which is also the main ingredient of the suppositories) for both mother and child, SAB suspension, heat on the belly (cherry stone bags), and leg excercise for the babies.
posted by Omnomnom at 11:36 AM on May 13, 2011

I would just add that it's probably better to attempt soon after a bowel movement than when you're expecting one.

As a point of reference, my breastfed babies pooped 5 times a day. And I mean at like 6 months, not just during the newborn poop-after-every-feeding stage. Oh how I envied the mothers whose babies pooped every other day.
posted by ellenaim at 1:24 PM on May 13, 2011

It's not that hard to do. Just relax and be patient.
posted by St. Alia of the Bunnies at 1:35 PM on May 13, 2011

How far are you inserting your finger? You need to get past the internal sphincter, or it'll pop right back out. Assuming there is no intestinal blockage, you should feel a slight tug or pull on your finger. This means you're past the sphincter. You shouldn't need to go far. Obviously, inserting the suppository after a bowel movement would be helpful.

Also (and I apologize if this is a no-brainer for you) make sure you're using a water-based lubricant. Never, never use oil-based in a body cavity!
posted by pecanpies at 1:59 PM on May 13, 2011

Another thought, and I apologize if you mentioned this and I missed it. Are you warming the suppository to body temp prior to insertion? Make sure to hold it in your hand (in the wrapper) to let it warm before you insert. Trying to insert a cool suppository could cause the external sphincter to clench involuntarily.

(FYI - nursing student - not a mom)
posted by pecanpies at 2:03 PM on May 13, 2011

Gripe water was a savior for us with colic. We would use a much a smaller amount than recommended with decent results.

Also, pumping and bicycling legs. Change of environment. Being in a sling where the legs are gently bundled underneath would help immensely. Baths. Full baths. Get in the tub with the baby. Have the baby immersed up to his/her chest. Bicycle and pump the legs in the bath. Rub the abdomen with some pressure ---- keep your hand open palmed and use the palm to massage, this way you'll be firm but not cause pain.

Put the baby in a sling and go to a park and swing. With the baby in the sling. I'm serious.

Baby dance. I would hold my son in both arms, and I would gently hop from one foot to the other. Sometimes I'd hop in a three step waltz movement. Do balllet plies with the baby in your arms, facing in or out depending on baby's preference and head holding ability. Deep sways in circles where you're moving your torso in an up and down circle while holding the baby. Any other baby dancing you can think of.

Lots and lots and lots of outside time, especially right before the colic would normally start up in the evening.

Change of hands. Sometimes being given to the other parent for a little bit can work wonders for no discernible reason, or to another relative or person in general.

And, geez, make sure you have someone you can absolutely call any time of day no matter what, because if the colic is anything like Toddler Zizzle's, you may need to put the baby down and get out of the room to keep your sanity. In which case, make sure you can call someone. They don't necessarily have to come over, but colic can seriously wreak havoc with a parent's mental well being. It is critical to have good support, and you can absolutely MeMail me any time, and I will be happy to call you.

Because I have been there. And it sucks so hard, and when you're doing everything you can and nothing seems to be working....that sucks even more. I really, really get it. I don't wish colic on anyone, baby or parent.
posted by zizzle at 4:00 PM on May 13, 2011 [2 favorites] more thing!

Shock the baby out of it.

My father-in-law, as a joke, sent us three of these discs ---- one was thunderstorms, one was the ocean, and one was the rain forest.

You know what? They freaking worked for a bit! Toddler Zizzle would stop crying, listen, sometimes he'd yawn, finally freaking eat or work out the gas or whatever it was he needed to do, let out a big yawn, and go to sleep.

It didn't work all the time, but when it did, it was HEAVEN.
posted by zizzle at 4:15 PM on May 13, 2011

screaming because of difficulties passing wind and stool

It is normal for babies to get worked up and then fart from getting worked up, and super-common for newborns to spend quite a while going crazy before managing a poo. It is a complex series of actions -- tighten this, loosen this, good grief; what's going on? -- and newborns are utterly overwhelmed by pooing. Very difficult while it lasts. But it goes away pretty quickly. None of this means they are in pain from the farts or poo.

I am a little worried that you might be dealing with fuss on top of normal new-baby fuss because of all the folk wisdom being thrown at you about teas &c. These things are not really a great idea, common as they are. One in 10 Infants Get Herbal Supplements That May Pose Risks, Study Finds; also read this; "In a healthy baby, anything other than breastmilk is more likely to cause problems rather than solve them. Giving baby substances other than breastmilk can alter the intestinal flora and reduce the protective qualities of exclusive breastfeeding, thus making baby more susceptable to illness and allergies." There is no science backing the use of these sorts of remedies and there is science to say that they can be harmful.

The anti-gas suspension is discussed at the 2nd link; it has "not been shown to be more effective than a placebo when the study focused on baby's total crying time and the severity of colic-like episodes."

Good info here re. mom's diet; drinking X tea does not make X milk.

All cultures have these wives' tales about teas, and about stuff the mother should or shouldn't enjoy, and they are different from culture to culture, and never found to be useful when researched. Occasionally they are very dangerous. Do do your Googling on 'remedies' and make sure you are not at best wasting your money.
posted by kmennie at 6:53 PM on May 13, 2011

Many years ago when I had a colicky baby my doctor tried to give me barbiturate drops to put in her bottle. I passed. I can't help but wonder if these suppositories you're giving the baby for colic have a barbiturate to calm the baby rather than something for constipation, since you emphasize that constipation is not the problem. If so, you might check the subject out very well before you use them.

I would recommend the suppository be warmed in your hand first, the baby be on his tummy with legs dangling over someone's lap - both good points - and I can also tell you that if the baby is crying, inserting the suppository will be easiest when he's inhaling rather than exhaling - taking that good deep breath for a yell seems to relax the sphincter. It helps to gently squeeze the little butt cheeks together once the suppository is in to help keep it there for a few minutes until it melts.

Good luck to you - believe it or not, they do eventually get past the colic.
posted by aryma at 10:09 PM on May 13, 2011

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