The first time I tried to persuade my daughter, Scotia, to “swallow some of this yummy-tasting medicine,” she took a spoonful, gagged and spat it back out. Obviously, the bubble-gum-flavoured acetaminophen wasn’t a hit with my tot, even though pink is her favourite colour. When she saw me reaching for the bottle again, she sealed her lips tight and started to cry.
Coaxing kids to take their medicine can often end up with someone in tears. Liquids may taste yucky, pills are hard to swallow, eye drops seem scary and suppositories are, well, suppositories. “Parents should try to remain calm, matter-of-fact and positive,” advises Elizabeth McLaughlin, a paediatric psychologist at the IWK Health Centre in Halifax. “If your child sees you looking worried or uncomfortable, she’ll quickly pick up on those feelings.” It also helps to have an arsenal of expert tips and tricks on hand. Read on for ways to help the medicine go down (or on or in).
It can be tricky enough getting drops into your own eyes, never mind a squirming toddler’s. “Try to do it in tandem if you can,” advises Falko Schroeder, a nurse practitioner at the Parkdale Community Health Centre in Toronto. Have Dad, Grandma or the sitter distract junior while you dispense the drops. If your child absolutely refuses to open his baby blues, squeeze the drops into the inner corner of each eye while he’s lying down and they will naturally flow in when he opens them. Before applying drops, roll the bottle between your hands or under warm water until drops are lukewarm.
The smell, taste or consistency of many liquids can be a turnoff for children of any age. Whenever possible, choose medications that are flavoured and tailored for kids. “As the saying goes, just a spoonful of sugar helps the medicine go down,” says paediatrician Ari Brown, co-author of Toddler 411: Clear Answers & Smart Advice for Your Toddler. Compounding pharmacies can make even the foulest-tasting medicines more palatable. And many traditional pharmacies offer a service called FLAVORx: For about $3, you can choose from dozens of flavours—including watermelon, bubblegum and chocolate-covered cherry—to improve the taste of your child’s medicine. “You can also concoct your own favourite mixes at home,” suggests Brown. However, if you use a drink (such as juice, formula or chocolate milk) to dilute medicine, check with the pharmacist first and use the smallest amount possible so it all gets into your child. And don’t sweat the sweet stuff: “There are ways we can camouflage the bitterness without having to add sugar to a product,” says Anne Marie Picone Ford, who is co-owner of a pharmacy that offers compounding in Moncton, NB.
Keep in mind also that giving liquid medications to a baby or struggling toddler is a lot easier—and more accurate measurement-wise—if you use a plastic syringe or dropper rather than a spoon. If nausea, vomiting or irritability makes oral acetaminophen too hard for your tot to take, ask the pharmacist to substitute a suppository form.
Many kids (and adults) have trouble swallowing pills or capsules. Try to select a chewable tablet instead, advises Picone Ford. “They usually have an orange or cherry flavour to mask the bitterness, and they dissolve quickly.” Some pills can be crushed and mixed with a small amount of your child’s favourite food or drink—ice cream, applesauce or chocolate milk, for example. Make sure you use the least amount of mix possible since you want your child to eat or drink the full dose of medication. Always check with your pharmacist before mixing or crushing medicine in with food or drink. Certain medications may irritate your child’s stomach if you destroy the protective coating. And some mixtures—say an antibiotic, such as erythromycin, and acidic foods, such as applesauce or orange juice—may make the medicine ineffective.
If there’s no way to get around pill swallowing, help your child practise the technique using different-sized candies. “A common mistake many parents make is starting out with Tic Tacs, which are as difficult to swallow as small tablets,” says McLaughlin, who works with kids who have acute chronic illnesses. “We start with the smallest sprinkles and don’t move forward until the child is comfortable.”
Substitute a cream for an ointment whenever possible, advises Picone Ford. Petroleum-based ointments can sometimes sting, and many kids don’t like their sticky texture. Apply steroid-based creams (such as those used to treat psoriasis) sparingly, or you can create a rebound effect. “Creams are always more pleasant if you throw in a nice massage to go along with the rubbing in,” adds Brown.
The bottom line
While many parents shudder at the very thought of suppositories, they can be a good alternative if your child is very sick, vomiting or refusing other forms of medication. “It’s a very temporary discomfort—more often for the parent administering it than for the child,” says Picone Ford, who has seven children of her own. To make the procedure easier, one Halifax mom coaches her two-year-old to blow imaginary bubbles, which both relaxes and distracts her. It also helps to bring the suppository to room temperature and to warm your fingers under warm water. Avoid using Vaseline, which creates a barrier to the drug, says Picone Ford.
Medicinal do’s and don’ts
DO offer an explanation
Tell your child in simple, age-appropriate language what the medicine is for and how it will help her feel better. Kids are more co-operative when they understand the reason for doing something, says Elizabeth McLaughlin, a paediatric psychologist at the IWK Health Centre in Halifax.
DON’T forget a reward
“Stickers can be a very powerful motivator,” says Falko Schroeder, a nurse practitioner at the Parkdale Community Health Centre in Toronto. You can also try the “first medicine, then something preferred” approach; for example, “First you take your medicine, then we go to the park.”
DO offer choices
Let your child decide which spoon or cup he wants to use. Your child will also feel more in control if you let him take an active role in managing his medication whenever possible.
DON’T hurry it
Choose a quiet time and place to administer medication. “That’s probably not when you have other children demanding your attention and you’re feeling stressed and rushed,” says McLaughlin.
This article was originally published in December 2008.