A Spoonful of…Something: Helping the Medicine Go Down

spoonful of sugar

Some kids don’t seem to mind taking medicine. Mine did. They didn’t really take any medicines on a regular basis, so whenever they needed something for an illness, we were stuck trying to introduce a new foul-tasting foreign substance. Add to that the fact that they were grumpy and felt like crap, and…well, let’s just say our old house had an Infant Advil stain on the kitchen ceiling.

But it’s not just my two kids—I know this because I’ve admitted multiple children to the hospital for IV antibiotics because their parents couldn’t get them to take their medicine at home (and also because Mary Poppins sang a song about it). So whether your child has an acute illness or you’re starting a new daily medicine, here are some tips for success:

1. Engage only when necessary. Most childhood illnesses go away on their own. In addition to the cost and potential side effects of medications, the battle to get the meds in your kid can be fierce. Avoid it if you can.

2. Reconsider the route. As a doctor, I have lots of choices. I can give shots or start an IV. As long as somebody can hold the child still, those don’t require much cooperation. You don’t have those options at home, but there are a few you may not have thought of. Tylenol comes in a suppository form to give rectally—not the most pleasant thing to do, but it works in a pinch (sorry). There are ADHD medicines available as a patch and nose sprays for allergies. Strep throat can be treated with a single shot instead of several days of amoxicillin. If what you’re doing isn’t working, ask your doctor if there is another option.

3. Use the chews. I find that chewable medications are underutilized in pediatrics. Many common medications (Tylenol, ibuprofen, amoxicillin, allergy medicines, and many more) are available in chewable form, and they taste pretty good. There are also some dissolving tablets that don’t even require chewing. The dosing can be difficult (liquid medications are easier to adjust for weight), and they are typically more expensive. Be sure your child is developmentally ready to safely chew and swallow small objects. Also keep them out of reach and don’t refer to them as “candy” or “treats.” Even yummy-tasting medicines can lead to overdoses.

4. Sprinkle it. Some medications are available in capsules that can be opened and sprinkled on applesauce, yogurt, or something similar. Sprinkle the medicine on only a small amount of food (like a spoonful), so they will get the whole dose even if they don’t eat all the food. They sometimes taste better than their liquid counterparts. We do this pretty commonly for ADHD medicines, antibiotics, and seizure medicines. Ask your doctor if this would work for you.

5. Disguise it. For small pills, you can sometimes place the pill in a spoonful of chocolate syrup or applesauce, a bite of bread, or another creative vehicle. This can be done either in secret, or with your child’s knowledge. Often, your pharmacist can flavor liquid prescription medicines (usually for a fee). Allowing your child to choose the flavor can give her some control and make the situation more pleasant.

6. Shoot for the cheek. With liquid medicines, you can use a dropper, syringe, measuring spoon, or measuring cup. Whatever your chosen instrument, try to direct the medicine into the back of the cheek—this avoids concentrated taste buds as well as the tongue thrust reflex. Squeezing your baby’s check together will also make it harder to spit the medicine out. If this doesn’t work, consider a medication-dispensing pacifier.

7. Repeat as needed. If your baby immediately spits out the medicine and you feel like the whole dose came out, it’s ok to repeat it. If it’s been more than a few minutes and she spits up the medicine, wait until time for the next dose.

8. Start small (and sweet). It’s hard for some people to believe, but I have several 3-year-old patients that swallow pills. There’s nothing special about these kids (I mean, they’re great, but they don’t have any pill-swallowing superpowers). But if they have a condition that requires medication only available as a pill, there’s not much choice. Start with small pieces of candy (Tic-Tacs or mini M&Ms work well). This eliminates the fear of a bad taste if the attempt is not successful. Place one on the back of the tongue and then give your child a sip of water. Once he has this down, real pills are an easy next step. Another option I recently heard about (from the parent of a 2-year-old) is to place the pill on the top of a sippy cup spout and then have them drink. Pill and juice go down together.

9. Chase it. Whether the medicine is a pill, a chewable, or a liquid, they don’t tend to taste fantastic. A couple sips of juice or chocolate milk (while not great nutritional choices) can go a long way towards neutralizing both the aftertaste and the bad experience.

10. Call in reinforcements. Sometimes you may need some help holding your child still while you try to get the medicine where it needs to go (think: eye drops). Grab a spouse or friend (try to avoid older siblings) to gently restrain your child. Try to avoid making the experience any more threatening than it needs to be, and always reward your child when done with hugs and praise.

If you still can’t get it down, don’t get angry or frustrated. Consider calling your pediatrician for further advice, to try a different form, or to see if it might even be ok to forego the medicine altogether. As always, keep the medicines out of reach or locked away—you might find that your kids enjoy them more than you thought.

Thanks for stopping by–if you have any other tips, or any questions for me, leave a note below! -Chad