Beyond a spoonful of sugar: Helping kids take their medicine

“Eeeewww! Gross! I don’t wanna!” If you’re a parent or caretaker of a small child, you’re probably familiar with this reaction to medication. Often too young to know how to swallow tablets or capsules, most toddlers and young children strongly resist taking their medicine –and parents or caretakers may end up wearing the rejected medicine.

Why is taking medicine such an issue for little kids? Small children don’t usually tolerate strong tastes well, and most medicine isn’t tasty. Some young children may become afraid of taking medicine because of unpleasant or scary associations; or they may sense a parent’s concern, which can contribute to increased tension and anxiety. While older children can (sometimes) be reasoned with, younger children may simply not understand what is happening and why they need to take the medicine. Unfortunately, kids’ poor experiences early on can colour all their future encounters with medicine.

So what can you do to help the medicine go down? Julie Andrews may have sung about using a spoonful of sugar, but we know that’s not a wise approach. Most kids already ingest too many sugary drinks and treats. It may be tempting to tell your child the medicine tastes good—when it doesn’t—just to get it down the hatch, but this can create confusion and distrust. However, there are quite a number of things you can do to help make the situation easier for you and your child.

1. Shift your attitude. Children pick up on a parent’s vibes very quickly. If you’re anxious about giving them their medicine, your children will become anxious too. It may be hard to put on a happy face, since no parent likes to see their child sick, but a positive attitude will help. Routines like bath time, clean-up time, or story time create familiarity and foster a sense of comfort. You may find “medicine time” allows you to create a space in the day where taking their medicine is the focus for your child.
2. Empower your children. Give children age-appropriate information they can process. Help them understand why medicine will help them get better. Use role play to get them used to the idea of taking medicine when they’re ill. Give them a choice in how they take their medicine (a spoon, a dropper or a cup), when they take it (before or after daycare or school), and where (in the kitchen or while watching their favourite program).
3. Ask for help. These days, pharmacists are able to access a variety of compounds and forms of medication. Your doctor and pharmacist can help you navigate the available choices. For instance, perhaps the medicine your child needs can be given in a single dose daily instead of two or four times each day, to minimize occasions for conflict.
4. Improve the taste. If the medicine children must take comes in different flavours, let them pick out what they like most. Most pharmacists can use specially formulated products to increase the range of flavour options available to your child. Just be careful not to describe the medicine as candy or a treat so as to avoid creating confusion for your child about what they’re taking.

1. Numb the tongue. Eating a popsicle, sucking on ice chips, or nibbling on some frozen fruit before taking the medicine can help chill the taste buds sufficiently so strong flavours are muted. Offering a stronger-flavoured food item or a preferred treat after can help wash away unpleasant tastes. You may also find keeping some medicines chilled in the refrigerator can soften their bitterness.
2. Bypass the tongue. Rather than using a spoon to deliver the medicine, try using an eyedropper or a needle-less syringe. Keep your child upright and slowly squirt the medicine along the sides of your child’s mouth avoiding their tongue entirely. It may also help to gently stroke your child underneath their chin to get them to swallow.
3. Redirect their attention. Some parents find playing a game like peek-a-boo helps distract the child. Singing a song that includes actions can deflect your child’s attention.
4. Reward positive behaviour. Older children often respond well to incentives like stickers or tokens they can collect to trade up for a special item like a new storybook or small toy. You can use the stickers to count down the days as well so your child can anticipate when they will finish their medication.
5. Teach kids to swallow pills. If your child is eating whole foods well on their own, you can teach them to swallow pills. Offer your child the pill in a spoonful of yogurt or applesauce. The slippery texture of the food will help the pill go down more easily.

Watch out for these four pill-taking pitfalls. Some techniques might seem helpful, but can come with hidden dangers. Or they may simply not be as effective as you would hope. Here are a few cautions to keep in mind when giving your child medicine.

1. If you hide medicine in food, choose a small amount of food to make sure the child eats all of it. Otherwise you run the risk that they may only get a partial or incomplete dose, thus reducing the effectiveness of the medicine.
2. If your child spits out or vomits up the medicine despite your best technique, check with your pharmacist or doctor before repeating the dose. Some medicines can be given again without harm, while others may require you to wait a while to avoid giving your child too strong a dose.
3. If you want to use your child’s favourite spoon, that might work well to help them take their medicine, but you should always use the dosing tool provided (syringe, cup or special spoon) to measure the dose accurately first. Do not use regular dinnerware spoons to measure with, as size may vary and you could give your child too much or too little medicine.
4. If you’re tempted to crush or split a pill to make it smaller or easier for your little one to swallow, check with your pharmacist first. With some medications this is fine, but with others it can affect the way the medication is absorbed. For instance, the pill may feature a protective coating for a timed release or to prevent the stomach’s acids from reducing the medication’s effectiveness. If you expose the inside of the pill in a way it’s not designed to be, it may not work as well. Also, while crushing or splitting can make the pill smaller, it may increase the bad taste or leave sharp or rough edges that are difficult to swallow, so the trade-off may not be worth it in the end.

With a little trial and error, you can find the medication method that works best for your child.
There’s no one perfect way to get a child to take their medicine, but we hope that if you follow these basic tips and ideas, you’ll find something that works for your little one! Being sick is no fun, but when you find an approach to medication that works for your child, you can set the stage for a lifetime of good healthcare.

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