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Monday, December 5, 2011

How to get kids to take medicine

A recent facebook post discussed how to give medicine to children, but left out how to give liquid medicine. A reader asked for advice, and I wanted to expand my original answer.

The article:   Medical Mom: A spoon full of sugar helps the medicine go down


The facebook question:   She gives great advice on pills, but what about liquid medications that kids just WON'T swallow? I've tried putting it in his cheeks, but the flavor they mixed it with he hates :(


Of course, there is so much to giving medicine to kids.  They already feel sick for most of the medicines we give, and anything is distasteful when you feel sick, regardless of the flavor the pharmacist adds.  Some medicines have a horrible aftertaste that is difficult to mask.  Some upset the stomach.


If medicine is vomited within 30 minutes, it generally can be given again. If your child vomits more than 30 minutes after the medicine is swallowed, do not offer it again.


I don't miss the days of liquid medicines! My son (who suffered from many ear infections) spit out most medicine (and often vomited what he swallowed).  My daughter didn't need as many medicines as him, but as the expert vomiter (she would vomit whenever she didn't get her way as an infant) and expert manipulator, she had unique issues to get the medicine down.


Needless to say, I learned a lot of tricks trying to get them to keep medicines down.


Most liquids taste better cold, so check with your pharmacist if the medicine can (or should) be refrigerated.  Also ask if it can be mixed with juice or foods.  Some should be given on an empty stomach without food and only sips of water. 


Be sure you have a properly sized medicine syringe or medicine cup for all liquid medicines.  Shake the bottle well before dispensing.


If it can be mixed into juice, jelly, or yogurt, be sure to mix in a small enough volume that you can ensure your child will take the entire amount.  You can measure the amount of medicine in a syringe, then fill the remainder of the syringe with drinkable yogurt, juice, or whatever liquid is okay to mix with the medicine.  (Always ask your pharmacist first!) 



Sometimes using a medicine that comes in a capsule that can be sprinkled onto a spoon of yogurt, jelly, or applesauce works well.   Yogurt tubes are especially great for this if your child eats these. Put the contents from the capsule on the top of the open tube, and they suck it down as they enjoy the yogurt.  Ask your pharmacist if you can mix the medicine with foods first!  


For infants: Try squirting it in the inner cheek and blowing on the face. I don't know why, but it seems to make infants swallow.  You can also put it in a nipple and allow them to drink from the nipple, which bypasses most of the taste buds on the tongue! After the medicine is swallowed, use the nipple for water or formula/milk to rinse all the medicine down as long as it does not need to be given on an empty stomach. 


Preschoolers: This age might feel "big" if allowed to hold the medicine cup themselves.  Supervise closely so they don't spill it.  Praise when they did it!


Preschool and up: Offer a chocolate syrup chaser. Syrup is thick and masks a lot!  Another trick is to offer a popsicle (or ice) first.  This numbs the taste buds, making the medicine taste less noticeable.


Holding the child's cheeks to make them pucker their lips until swallowed sometimes works (though I found kids can still spit it out that way!) 


You can also have the pharmacist flavor most medicines, and if you pick the right flavor, it can help. Ask for suggestions, since the flavor added might not be the best for the particular medicine. 


Bribery works with preschoolers and up. (A thing I promised myself I would NEVER do... but once I had kids and realized bribery works, I reserve it for the really important things.)


As for most of my behavioral advice: praise a job well done! If they took the medicine, tell them you are happy they did.


When you think your child is able to swallow pills without choking, teach with small candies, such as Tic Tacs or mini M&Ms.  I always suggest using a cup with a straw, since when you drink out of a cup you tilt your head back, narrowing the throat.  A straw allows you to keep your neck neutral. Once swallowing a small candy is mastered, you can use real medicine capsules or tablets, as long as the dose is correct for the child's weight.


Sometimes making a game of it works. My husband came up with this trick for our daughter when she was 5-6 years old.  Remember she was the expert manipulator.  She threw a fit about taking a medicine and made getting out of the house for school on time difficult a couple of days. He suggested that if she was ready for school by 7:15, she could throw a fit for 10 minutes. If she wasn't ready until after 7:20, she could only throw a fit for 30 seconds.  Either way we would set the timer for her fit, then she would take the medicine.  Of course we knew she'd never be ready early (and she really couldn't tell time well in kindergarten) so when it was time for medicine, we set the timer for 30 seconds and told her to throw a good fit.  She threw a great fit, then took the medicine without a problem. It was as if owning it worked for her, and she then took the medicine each day for the rest of the week after setting the timer for a fit.  By the end of the week she could hardly throw a fit she was giggling so much!


The most important thing is to remember why you are giving the medicine.  If it is an antibiotic or other medicine that is important to completely take, then it is more important than if you are simply trying to give a fever reducer.  A fever reducer might make your child feel better, but it really isn't required.  If it is required, then you need to play hard ball and do whatever it takes to get the medicine down.  


What has worked for your kids to take medicine?  Please share your tips!