9 Clever Ways to Help the Medicine Go Down

"Taking prescription medicine is like any other thing you want your child to do," Dr. Altmann says. "Act positive about it. Talk about 'medicine time' like it's an enjoyable thing. Kids can pick up on negative tone and body language." Alissa Robinson, of Colorado Springs, discovered a way to help ease the stress of medicine time. "I don't let my 10-month-old see the medicine," she says. "I lay her on the floor, cover her eyes a couple of times playing peekaboo, then cover her eyes again while I put the syringe in her mouth. She swallows before she knows what happened."

Kids tend to spit out bitter-tasting meds. To avoid this, some parents continue to use syringes and droppers even when their children are old enough to drink out of a cup. "I always use a syringe so I can squirt the medicine along the inside of my kid's cheeks and keep it off the tongue," says Blossom Ruso, a very experienced mother of six from Santa Cruz, California. To do it correctly, slide the syringe or dropper along the cheek, toward the back of the mouth, and squeeze it slowly, recommends Christopher Tolcher, MD, assistant clinical professor of pediatrics at the University of Southern California. Or you can rest a dropper halfway back on the tongue and have your child suck on it.

Your pharmacist can add flavors such as chocolate, root beer, and watermelon to liquid meds for just a few extra bucks. "Sarah was on antibiotics for five months straight when she was just over 1 year old -- every day!" says Heather Greene, of Emmaus, Pennsylvania. "Luckily, we had her amoxicillin flavored, and she liked it. She called it her 'moxie.'" Even OTC meds can be flavored by your pharmacist -- the cherry taste of a cough medicine can be masked by a banana flavor your child prefers.

"When my 2-1/2-year-old was on antibiotics, I gave him the option of taking his medicine in a dropper or in a cup," Dr. Altmann says. "Having a choice gave him a sense of empowerment. He didn't struggle with me because he felt like it was his decision." You can also let your child decide when she's going to take it -- say, before or after bathtime -- or what flavor she wants.

"I give my 5-year-old son ice and have him suck on it for a bit before giving him his medicine," says Gail Mithoff, of Mission Viejo, California. "It helps numb his taste buds so the medicine goes down smoothly." Use ice chips, since larger pieces are a choking hazard, and only for older kids. An ice pop also works well. Or you could put the medicine in the fridge. "Some, like steroids, have a bitter edge and taste better cold," Dr. Tolcher says.

Eyedrops are hard to give, especially when little ones are flinching and squirming. Try this tip: hold the bottle in your hands for two to three minutes to warm it to body temperature -- sometimes cool drops don't feel good! Next, lay your child down and aim for the inside corner (the fleshy part) of her eye. Even if her eyes are closed, some of the drop will run into the eye when she finally opens up. Of course, you may still need the help of another adult to hold her down.

Have your kid pretend to give a stuffed animal medicine before she takes hers. "It will help her get comfortable with taking medicine," Dr. Altmann says.

Don't lie to your children and tell them their medicine is going to taste yummy if it's not. "Once your kids get to the age of reason -- usually 3 and older -- you can explain that the medicine is going to make them feel better," Dr. Tolcher says. "Appealing to kids' sense of reasoning can be a powerful tool." It works for Kristine Mancusi, of Wallington, New Jersey. "I tell my 6-year-old daughter and my 2-year-old son the truth -- that whatever prescription I am giving them will make their hurt go away," she says. "I'm lucky. They take it, and that's it." And don't refer to medicine as candy. "Never do that; you don't want them to seek it out and risk overdosing," Dr. Tolcher says.

If your child has an easier time taking chewables than liquids, ask if that's an option. "With some medications you can ask for a higher concentration so you can give less," Dr. Tolcher says. "For example, instead of one teaspoon of a drug at a 50-milligram concentration, your child could take half a teaspoon of the 100-milligram concentration. It's the same amount of medication in a smaller dose."

Even though over-the-counter medicines don't require prescriptions, they can still be dangerous, says Allison Muller, MD, clinical managing director of the Poison Control Center at the Children's Hospital of Philadelphia. According to the American Academy of Pediatrics, several studies indicate that OTC cold medications are not eff ective in children younger than 6 and can have potentially serious side effects. For that reason, always check with your pediatrician before administering medicine to your child. Today, more and more doctors advise parents to use traditional treatments instead (lots of fluids, rest, and TLC).

So it's always best to ask your doctor or pharmacist if a specific medication is safe. For instance, if your little one has a cold, the flu, or chickenpox, don't give him any product with aspirin or salicylates (this includes ibuprofen and regular Pepto-Bismol), which can cause a rare but sometimes deadly condition called Reye's syndrome. Acetaminophen (Tylenol) is a safer alternative. Also, some cough and cold formulas contain alcohol, which your doctor may not recommend.

As for prescriptions, discuss these with your pediatrician before leaving her office. The FDA recommends this checklist:

• What is the drug, and what is it for?
• Will the drug interfere with any other medications my child is taking?
• How many times a day will my child need to take this medication, and how long does she need to be on it?
• Are there any side effects I should expect or be concerned about?
• What if my child misses a dose?
• How soon will symptoms improve?
• Is there a less expensive generic alternative that's as effective?

When you pick up the medicine, look at it before you leave the pharmacy. Is it what you expected -- the chewable pills the pediatrician described and not capsules? Also review the dosing instructions that come with the medication. Unclear about anything? Ask the pharmacist or call your doctor.

Liquid medications usually come with their own cup, spoon, or syringe to ensure you give your child the correct amount. "Always use the dosing device that comes with the medication," says Dr. Tolcher. "These are more accurate than a kitchen spoon, which can vary in size and make dosing inconsistent and inaccurate." If you lose these measuring instruments, you can always use one from a different medication or pick up a replacement at the pharmacy. (Just make sure the new one is marked with the units you need -- milliliters, teaspoons, or both, for example.)

Dosage cups For kids old enough to drink from a cup without spilling, these cups have numbers on the side to help you pour the right amount. Measure by placing the cup at eye level on a flat surface.

Dosing spoons They're like test tubes with spoons at the end and work best for kids who can drink out of a cup, but they're more likely to spill. Measure at eye level, then have your child sip from the spoon.

Droppers These are for infants and young children who can't drink from a cup. After you measure at eye level, give the dropper to your child quickly because it may drip.

Syringes They allow you to squirt medicine into the back of a baby's or young child's mouth, where it's less likely to spill out. Some syringes come with a cap to prevent medicine from leaking. These caps are a choking hazard, so be sure to remove them before putting the syringe in your child's mouth. Research shows that parents measure most accurately with syringes versus cups. So when exact dosing really matters, first measure with a syringe and then place the medicine in a cup, if that's what the child prefers.

If you're like most parents, you probably have old medications and leftover prescriptions taking up space in your medicine cabinet. What to toss:

• Get rid of any old meds you aren't using or that have expired, plus outdated products such as syrup of ipecac (not recommended by the American Academy of Pediatrics), mercury thermometers (can break and expose your child to mercury), hydrogen peroxide (good for laundry, but soap is better for cleaning wounds), baby aspirin (can cause Reye's syndrome), and OTC cough and cold meds for kids under 6 (not recommended by the FDA).
• Throw away any old antibiotics. "Always see your doctor if your child has symptoms you think may need antibiotic treatment," says Tanya Remer Altmann, MD. "It's important that your pediatrician decide which antibiotic is needed. Giving an antibiotic when it's not needed, giving the wrong antibiotic, or giving the wrong dose can cause serious problems."

Originally published in the December 2008 issue of American Baby magazine.

Updated February 2010

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