Rectal irrigations

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This resource is for educational purposes and should only be followed if prescribed by your physician.
Always speak to your physician before initiating rectal irrigations for your child or youth.

If you have any questions, reach out to your health-care provider.

Before you begin

• Check baby’s belly to make sure it is not firm or tender
• Make sure baby has not passed any watery, foul smelling, or bloody stools
• Baby should be alert, feeding well, and not vomiting before proceeding with irrigation

Supplies

• Foley catheter: this is the flexible tube your doctor will give you to use. Do not insert any other tube. Size is based on age (20 French catheter for babies under 1 year, over 1 year should use a 24 French)
• 60 ml catheter-tip syringe
• Water soluble lubricant
• Saline solution (this can be warmed for comfort)
• 2 bowls or basins
• Towels or absorbent pads/incontinence pads
• Diaper

Steps

1. Wash hands
2. Wrap baby in a towel or blanket leaving buttocks exposed and lay them in a comfortable position on a towel or incontinence pad
3. Pour saline solution into one of your bowls and then use your 60 ml syringe to withdraw 20 ml of saline solution. Set the syringe aside
4. Apply the water-soluble lubricant to the end of your foley catheter and then gently insert it into the rectum about 6 inches or until you hit resistance. Place the other end of the catheter into one of the empty bowls so that stool or gas can run into it
5. You can move the catheter around or push it further into the rectum to let out as much gas and stool as you can
6. Next, take the end of the catheter from the bowl and attach it to the saline-filled syringe. Slowly push the plunger to make the saline solution flow through the catheter into the rectum
7. Once you have injected the 20 ml solution, remove the syringe and place the free end of the catheter into the bowl to drain. Hold the catheter at the same level of the anus so it does not fall out
8. Let all of the saline solution drain from the rectum. Then twist/spin the catheter around and gently push it a few inches further into the rectum.
9. Repeat steps 6 and 7 with another 20 ml of saline and continue this process until the fluid draining from the catheter is clear. If nothing is draining out, you can try removing the catheter and re-inserting it (step 4). DO NOT keep instilling saline if you have not been able to remove the fluid/stool.
10. After everything has drained out, wash and dry baby’s bum and apply cream as needed. Place a clean diaper
11. If the fluid does not drain passively, you can withdraw the fluid using the syringe.

Remember

• NEVER force the tube
• Avoid tugging on the catheter. You can hold it in the same place for a few minutes to help remove any drainage that does not come out from the saline irrigation
• You can move the catheter back and forth in the rectum slowly to help move stool that may be stuck in the colon
• If nothing drains from the rectum after you have inserted the saline you can try massaging baby’s belly or change their position. You should also check that the catheter is not blocked (by food or thick stool)

STOP and call your doctor if:
- your baby has fever at any time
- there is no drainage from your irrigations
- baby looks unwell
- you notice any fresh bleeding on the catheter or blood in the stool
- stools are foul-smelling or more liquid than normal
- baby's belly becomes big, hard or tender to touch
- baby starts vomiting or has a change in color, or becomes more sleepy