Several children have been poisoned one fatally from phosphate enemas, which were previously thought to be safe in children.
In one instance a two and a half year old was admitted to hospital, after receiving an enema for chronic constipation. She was subsequently diagnosed as having absorbed the contents of the enema, which nearly killed her, although she was eventually saved.
This is one of several similar instances in North America, including the death of an eight month old baby.
Although the British National Formulary only recommends that the dosage for a phosphate enema be reduced in children, Pharmax, its manufacturer, does not recommend its use in children under 3 and then cautions about its use in children over that age according to body weight.
Writing in the Lancet, the Department of Child Health and Welsh National Poisons Unit, at the University of Wales College of Medicine, concluded: "We recommend that phosphate enemas should not be used in children aged under 3 years, and that they should be used only with caution at reduced doses in older children."