Sick notes

Suppositories are popular on the Continent ... soft and painless to insert. But would they be popular with Harry?

It should have been idyllic. A post-Christmas holiday in the Alps, a chalet surrounded by snow-capped peaks, the children sledging and learning to ski ...

On the fourth day, however, Harry, our six-year-old, started to go down with something: he looked pale, said he felt wobbly and had a slight temperature. I dosed him up with Calpol and hoped it would go away. On the fifth day he developed a real fever and lay, face burning, on the sofa while we drank gluhwein and hoped for the best.

On day six, when he was no better, my partner, Bernard, took him to the doctor. They returned with a diagnosis (severe flu and an inflamed throat), advice (plenty of rest) and a prescription for suppositories. The doctor said they were a type of anti-inflammatory that would help soothe Harry's sore throat.

Suppositories are soft pessaries inserted into the rectum. This type of medication is popular on the Continent, especially for bringing down a high temperature in babies and small children who may be vomiting or who are likely to spit medicine out. Another advantage of using this route is that drugs are more rapidly absorbed into the bloodstream. Suppositories are less frequently used in Britain for patients who cannot take drugs by mouth or for medicines that might be destroyed by the stomach's digestive juices. They are soft, painless to insert, melt easily and come in different sizes. But would they be popular with Harry?

We were sceptical about giving him anything but paracetamol, but by this time we were desperate. I had never seen Harry so miserable: his mouth and throat were so sore that he wasn't even able to sleep. Perhaps the laissez-faire, English approach was wrong; maybe anti-inflammatories would help and we should be a bit broadminded. Bernard went out to pick up the prescription.

That afternoon, we discussed how to broach the subject with our son, sensitive at the best of times about taking strange medicine. His reaction was: "Yuk." We tried to make it into a joke; he didn't laugh. Neither was he convinced that it wouldn't hurt and could make him better. We couldn't persuade Harry to let us insert the thing, or to insert it himself, and we certainly weren't going to force him: it might traumatise him for life.

After a few nightmarish days we were glad to get home, where Harry was diagnosed as having mouth ulcers caused by the herpes virus. The virus had probably triggered flu-like symptoms but it was the ulcers that were making his mouth and throat unbearably painful. He was prescribed acyclovir, an antiviral drug, to be taken orally. The ulcers cleared up within a few days.

Friends hearing our tale were divided in opinion according to nationality. One (Italian) said the English had anal-retentive hang-ups about suppositories; others (English) were horrified at the notion, arguing that they carried overtones of sexual abuse. So are we Brits prudish or just sensitive?

Dr Beate Kampmann, a German-born paediatrician at St Mary's Hospital, London, says that while paracetamol suppositories are useful for reducing fever in babies and infants, they are not suitable for older children.

"By the age of six, a child has developed an awareness of his private parts," she says. "Suppositories should not be forced on a child of any age who objects or who is anxious about them." Parents should ask the doctor to prescribe the medicine in oral form, she advises.