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Got a kid who hates taking medicine? What to do.

Posted by Dr. Claire McCarthy  August 13, 2012 06:59 AM

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My middle daughter, Elsa, hated taking medicine when she was little. She would fight me tooth and nail--and often once I actually managed to get medicine into her, she'd glare at me and vomit it back up, usually all over me.

As hard as it was, it taught me a lot about do's and don'ts when it comes to giving meds to kids who really don't want them. My patients and their parents have taught me a lot, too. In an attempt to save you some trouble (and from being covered with medicine-filled vomit) here's a summary of what I've learned from Elsa and others:

Only give medicines if really necessary. This sounds obvious, but often parents do give medicines that aren't completely necessary. Like acetaminophen for a low-grade fever. Or cold medicines (they don't really work and can be dangerous). Talk to your doctor about which medicines your child really needs and which are optional. This will help you when you...

Take charge of the situation. Make it clear to your child that taking the medicine is non-negotiable. Kids are smart; if they sense any wiggle room, they will refuse even more. You don't have to be all fire and brimstone, though; it's totally okay to...

Use incentives. We all are more likely to do things if they are worth our while. "If you take your medicine quickly, we will have time for an extra story." Or "I know you don't like your medicine. How about we have a little ice cream after to make the taste go away?"

Use the proper implement for liquid medicines. Don't use a spoon--too much chance for spillage (and, unless you use a measuring spoon, too much chance of giving the wrong amount). My personal preference is a medication syringe (most pharmacies carry them). If you have a preschooler or older who freaks a bit at getting stuff squirted in his mouth and will cooperate, use the medication spoons that have a cylinder for measuring as a handle (also available in pharmacies)--it allows you to pour out a little at a time.

When squirting into a mouth, remember:
  • Aim back (but not too far back) and to the side. If you go too close to the front it's easier to spit out, but if you go straight back the child may gag.
  • Don't squirt all at once. As tempting as it is to get it over with, if you don't want to be wearing it, wait until they swallow each bit before giving more.
  • If you've got a squirmer: hold your child so that they are leaning back. Put the arm closest to you behind your back, and hold the other one down with the hand of the arm that's cradling them. If you've got a kicker, you can put their legs between yours.
A chaser may help. Something strongly sweet is often effective--I've had good luck with chocolate syrup. Honey is good too--but never use in a baby less than a year old, because of the risk of botulism. With really nasty-tasting ones, I've sometimes filled a syringe with chocolate syrup and alternated medicine with chocolate. Eating some crackers can help kill the taste too, or brushing teeth (which is good to do after giving iron or iron-containing vitamins).

Use the smallest volume possible. Your doctor will likely need to help you with this one--whenever they prescribe something, ask if there's a way to do it in less volume. For example, 250 mg of Amoxicillin would be 5 mL of the 250 mg per 5 mL formulation--but just a smidge over 3 mL of the 400 mg per 5 mL one. Which can be a big difference with some kids.

Consider flavorings. Some pharmacies will do this. However, it's not always possible and it doesn't always help...so it's something I recommend only when all else fails.

Consider chewables, or crushing a tablet. You'll need your doctor's help on this one, too. The chewables don't always taste wonderful, but some kids just take them better. And a crushed tablet mixed with a little bit of something soft and sweet (like pudding) may be an easier sell than a big syringe of liquid (my personal preference is to mix crushed tablets with food, not liquids--they often settle to the bottom of liquid or get stuck to the sides of the cup or bottle).

My last piece of advice isn't so much advice as a plea...

Tell your doctor if you can't get your child to take the medicine. I can't tell you how many times parents have just given up and not told me, even on important medications like antibiotics. Sometimes stopping a medicine can be dangerous. And there's often an alternative--either a different formulation of the same medication, or a different medication, or a whole other treatment entirely.

After all, medicine works best when parents and doctors think creatively--and work as a team.

 
This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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