What you Need to Know about Suppositories

What is a suppository?
The Medical Dictionary defines a suppository as a solid but readily meltable cone or cylinder of usually medicated material for insertion into a bodily passage or cavity (as the rectum, vagina, or urethra). Its conical shape allows for easy and comfortable insertion. Once inside the body, it quickly melts at body temperature and allows for absorption into the blood.

What is it for?
Common conditions that may need the use of a suppository are fever, constipation and seizures. Uncommon conditions are for vaginal infections (vaginal suppositories), and for those who cannot swallow anymore. There are several medications available in suppository form. For adult use, there are suppositories for hypertension and vitamin supplementation; however, these are not yet available in our country. For pediatric use, the 3 most common medications in suppository form are paracetamol (for fever), glycerin (for constipation) and diazepam (for seizures).

When should a suppository be given?
It is important to have a prescription and instructions from your pediatrician or family doctor before giving suppositories, especially if it is your first time. It is best to seek advice on the proper dosage of these medications, which is computed based on your baby’s weight. Your doctor will also examine your baby for any sores or wounds in the anal area. She will also demonstrate or give instructions on how to insert the suppository.

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The 3 Kinds of Suppository:
Paracetamol
Some parents think that paracetamol suppositories are given if the fever is too high, but this is not the case all the time. Usually, this route is given if your baby is not able to take in medications by mouth, e.g., if your baby has fever and is vomiting. Sometimes, it may also be given if your baby has mouth sores.  

Glycerin
Constipation is variable for each person. In medical books, constipation is having bowel movement less than 3 times per week; however, for babies, this is not always true. Breastfed babies have variable bowel movements, anywhere from 1-2 times a day to once a week. The appearance of your baby’s poo is more important than the frequency. If your baby’s poo is soft or semi-solid, you’re good, but if it’s as hard as stone, and is accompanied by straining as the poo comes out, your baby might be constipated. If this happens, make sure to bring him to a pediatrician. She will probably work-up your baby to arrive at a proper diagnosis. The reason could be as simple as the milk or could be an actual anatomic problem, which could require surgery. This is where the glycerine suppository comes in. It is usually given to temporarily relieve the constipation or to cleanse the bowels, along with other medication and a recommendation to change the diet or milk.  

Diazepam
Diazepam suppositories are often given for actively seizing children, because they should not take anything by mouth. If this is the first time your child is having seizures, bring him to the emergency room as soon as possible. If your baby is already diagnosed with epilepsy or seizure disorder, your doctor will probably prescribe you with a diazepam suppository as a back-up, for when a breakthrough seizure happens at home. A daily maintenance medication is given as well. Your doctor will also compute for the appropriate dose and will instruct you on how to insert it properly.

What are the advantages of suppository use?
Suppositories are convenient and easy to use. They may be administered at home, after being given proper instructions. It also helps deliver medications when the oral route is impaired, as when a child is vomiting, without resorting to the IV (intravenous) method (for diazepam and paracetamol). It can be a targeted route of giving medication (for glyerin), delivering it to exactly where it is needed.

What are the disadvantages of suppository use?
If you have never inserted a suppository before, you may find it difficult or intimidating, especially if your child cries, screams or squirms. Side effects after insertion of the suppository include burning, itching, stomach cramps, soiling, flatulence (farting), and dehydration. Sometimes, it could trigger allergic reactions to one or more components of the suppository. Medically, suppositories have variable absorption because each person’s anatomy is different, so this means that the amount of drug absorbed by the body through this route may or may not be enough to produce the desired effect.  

Should I use a suppository for my baby?
Yes and No.
If you are doing this alone, without the advice of your pediatrician, NO.
If you have already sought advice of your doctor, and have received a prescription and proper instructions, YES.
It is best to ask your pediatrician about suppositories ahead of time, even if you don’t need it yet, so that when the need arises you are ready.  

Photo from sxc.hu