Giving Medicines and Enemas

Giving medicine. It’s sometimes quite a trick getting a child to take his medicine. The first rule is to slip it into him in a matter-of-fact way, as if it has never occurred to you that he won’t take it. If you go at it apologetically, with a lot of explanation, you convince him that he’s expected to dislike it. Be talking about something else when you put the spoon in his mouth. Most young children open their mouths automatically, like birds in their nest.
Tablets that don’t dissolve can be crushed to a fine powder and mixed with a coarse, good-tasting food like applesauce.

Mix the medicine with only 1 teaspoonful of the applesauce, in case he decides he doesn’t want very much. Bitter pills can be mixed in a teaspoonful of sugar and water, or honey, or maple syrup, or jam. Eye ointments and drops can sometimes be applied during sleep.
When giving medicine in a drink, it’s safer to choose an unusual fluid that the child does not take regularly, such as grape juice or prune juice. If you give a queer taste to his milk or his orange juice, you may make him suspicious of it for months.
Getting a small child to swallow a whole tablet or a capsule is difficult. Try putting it in something lumpy and sticky like banana and follow the teaspoonful quickly with a drink of something he likes.

Don’t give medicine without a doctor’s advice and don’t continue it without keeping in touch with him.

Here are some examples of why not. A child has a cough with his cold, and the doctor prescribes a certain cough medicine. Two months later he develops a new cough, and the mother has the prescription renewed without consulting the doctor. It seems to help for a week, but then the cough becomes so bad that she has to call the doctor, anyway. He realizes right away that the disease this time is not a cold but whooping cough. He would have suspected it a week before if he had been consulted. In that case the child could have been isolated immediately and would not have exposed unnecessarily a lot of other children.

A mother who has treated colds or headaches or stomachaches a few times in the same way comes to feel like an expert, which she is in a limited way. But she’s not trained, as a doctor is, to first consider carefully what the diagnosis is. To her, two different headaches (or two stomach-aches) seem about the same. To the doctor, one has an entirely different meaning from the other and calls for different treatment. People who have been treated.by a doctor widi one of the sulfa drugs or one of the antibiotics (such as penicillin) are sometimes tempted to use it again for similar symptoms. They figure that it produces wonderful results, is easy to take, and they know the dosage from the last time—so why not?
Serious reactions  occasionally develop  from  the use  of these drugs—fevers, rashes, anemia, bleeding from the kidney, obstruction to the flow of urine. These complications, fortunately, are rare, but they are more liable to occur the more often the drugs are used, especially if they are used improperly. That is why they should be given only when a doctor has decided that the danger from the disease and the likelihood of benefit-from the medicine outweigh the risks of treatment.

Cathartics (drugs .to make the bowels move) should not be used for any reason—especially not for stomach-ache— without consulting a doctor. Some people have the mistaken idea that stomach-ache is frequently caused by constipation, and want to give a cathartic first of all. There are many causes of stomach-ache (see Sections 689 to 691). Some, such as appendicitis and obstruction of the intestines, are made worse by a cathartic. Therefore, since you don’t know for sure what is causing your child’s stomach-ache, it is dangerous to give a cathartic.

Enemas and Suppositories.

A doctor sometimes prescribes an enema or suppository when a child becomes suddenly constipated, particularly if he is sick. During some illnesses these are safer than a cathartic given by mouth because they will not cause vomiting or irritate the small intestines. He may prescribe an enema for severe gas pains, as in 3-month colic or after an operation.
A parent should not give an enema or suppository for constipation or illness or pains until the doctor has made the diagnosis and prescribed the treatment. It’s particularly important not to give enemas or suppositories repeatedly for a tendency to constipation, because eventually they focus a child’s mind on his anus and bowels.
A suppository for constipation is slipped all the way into the rectum where it dissolves. It contains a mildly irritating material which draws moisture into the rectum and encourages a movement. A baby can sometimes be stimulated to move his bowels if you merely insert a lubricated thermometer or ear syringe tip or small enema tip into his anus and hold it there for a couple of minutes. This is an emergency treatment, on the doctor’s advice. It is unwholesome to use it repeatedly for constipation or toilet training.

The doctor will tell you what to put in the enema. A soapy enema is made by stirring a piece of mild toilet soap in the water until it is slightly milky. This is a little irritating and is less often given to an infant. Enemas can also be made with a half teaspoonful of table salt, or a teaspoonful of bicarbonate of soda, added to an 8-ounce cup of water. The water should be at about body temperature. You can give 4 ounces to a small infant, 8 ounces to a 1-year-old, a pint to a 5-year-old.
Place a waterproof sheet on a bed and lay a bath towel over it. Have the child lie on this on his side with his legs pulled up. Have a potty close at hand.
For an infant or small child, it is easiest and safest to use a rubber ear syringe with a soft tip of-the same material. Fill the bulb completely, so that you won’t be injecting air. Grease the tip with petroleum jelly, cold cream, or soap; gently insert it an inch or two. Squeeze the bulb slowly and not too forcibly. The slower you put it in, the less liable it is to make the baby feel uncomfortable and expel it. The bowel contracts and relaxes in waves. If you feel a strong resistance wait until it “gives” rather than push harder. Unfortunately, a baby is apt to push as soon as he feels something in his anus, so you may not get much in.
As you pull the tip out, press his buttocks together to try to hold the water in a few minutes to do its job of softening the movement. If the water has not come out in 15 or 20 minutes, or if it has come out without much movement, you can repeat tie enema. There is no danger from an enema’s staying in.
With an older child who will cooperate, you can use a syringe or enema bag or enema can with, a rubber tube and a small, hard-rubber tip. Don’t hang the bag higher than 1 to 2 feet above the level of the rectum -(the height determines the pressure). The lowest height that makes the water run in slowly causes the least discomfort and brings the best results.