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Getting Kids to Take Medicine

Glassy-eyed, feverish, with a throat so sore she could barely talk, my 4-year-old daughter was suffering from a doozy of a strep throat. And no matter how hard I tried, she simply would not take her medicine.

Finally, after a half hour of pleading and cajoling, I mixed the prescribed amount with a smidgen of apple juice, promised her some chocolate-turtle-fudge ice cream as a reward, and watched with weary satisfaction as she swallowed every last bit. All the while, I wondered, "Do other mothers have to jump through hoops when their children need medication?"

The answer, of course, is a resounding yes. Either because they hate the taste or they don't want to be pushed around or they just feel too sick to cooperate, children often refuse to take their medicine. As a result, resourceful parents develop all manner of tricks to make the medicine go down. "You have to be creative, because medication is a must if your child is going to get better," says Elizabeth Sugarbaker, M.D., a pediatrician in Clayton, Missouri. Following are some strategies suggested by parents and pediatricians.

Helpful Approaches

The Avoid-the-Taste-Buds Approach
The idea here is to help the medicine make a detour around the bitter taste buds, located on the back of the tongue. When Barbara Wagner, a mom from Malverne, New York, gives Kate, 1, and Jonathan, 4, liquid medicine, she places the dropper in their cheek pouch. "They don't taste it that way," she says. "And it's harder for them to spit it out."

The Spoonful-of-Sugar Approach
This time-honored tactic -- combining medicine with a little sweet-tasting food or drink to mask the bitterness -- does work much of the time. And the most effective camouflage, according to some pediatricians, is cherry-flavored syrup or white grape juice, although parents on the front lines often use kitchen staples such as applesauce or flavored yogurt.

The Makeover Approach
"Children make decisions about medicine based on what it looks like," says Wendy Klein-Schwartz, Pharm.D., a coordinator of research and education for the Maryland Poison Center, in Baltimore. "If they don't like its appearance, you're going to have trouble getting it down." In desperation, Joan Morgan, of Pelham, New York, added a drop or two of red food coloring to 4-year-old Madeline's medicine cup. The liquid was transformed from a chalky white to a pleasant pink. Madeline was enchanted -- and finished the entire dose with a smile.

The Avoid-the-Mouth Approach
If your feverish kid throws up whatever he swallows or refuses to take medicine at all, find out whether the medication is available in suppository form. (Blessedly, acetaminophen is.) The dosage is based on a child's weight, but always check with your pediatrician before administering.

The Sticker Approach
Is your child a Lion King fan? Get some Simba stickers, draw a jungle scene on a piece of paper, and let him attach a sticker each time he swallows a dose. It's even more effective if your pediatrician participates: When your child has finished all his medication, he can bring his completed artwork along on his follow-up visit to the doctor as proud proof of his accomplishment.

The "I'm All Grown Up" Approach
Your mission as the parent is to create the illusion that your kid is in the driver's seat. As soon as Gail Zoppo, of Woodbridge, New Jersey, let 5-year-old Amber hold the cupful of medicine, their battles stopped. One pediatrician puts her toddler twins' medicine into toy teacups, enabling them to take it on their own.

The Try-Try-Again Approach
In a crisis, call your doctor or pharmacist and ask if you can substitute another type of medicine. For instance, you may be able to obtain a better-tasting antibiotic made by a different company. Sometimes, the brand-name version of a drug has a more pleasant taste; in other cases, the generic is preferable. Often, a child may actually dislike the consistency of a medicine, not the taste; in this instance, a thicker or thinner liquid may do the trick.

The Just-Around-the-Corner Approach
It may be cheating, but if my daughter gets really sick in the month or so before her birthday and refuses to take her medicine, I resort to the "If you don't get better, we won't be able to have your friends over for a party" line. She'll just about fall over herself in her rush to get that medicine down. I often wish we could celebrate half-birthdays.

Ilana Wiles: Favorite Parenting Hacks
Ilana Wiles: Favorite Parenting Hacks

  1. In general, medicine isn't absorbed as quickly when it's paired with solid food or milk, explains Tom McGinnis, a pharmacist and deputy associate commissioner for health affairs at the FDA. "But if this is the only way you can get your child to take the medicine, it's fine," says McGinnis. Some exceptions: penicillin G and erythromycin lose their potency when mixed with acidic foods like applesauce, orange juice, or soda.
  2. Check with your pharmacist to make sure it's okay to crush a tablet. Some medications may irritate the stomach if you destroy the protective coating, or they may fail to do the job they're meant to do.
  3. Make sure your child swallows -- and doesn't chew -- a tablet after it has been crushed. Chewing can interfere with a time-release feature; a nonchewable medicine may be especially bitter; and some of the medication could stick to your child's teeth, preventing him from getting the full dosage.
  4. Don't overdo it. If you mix the medicine with too much of a particular food or beverage, your child might have trouble getting it all down and therefore won't receive the full dosage.
  5. Don't freeze the medicine or warm it up to make it more palatable. Temperature changes may alter the efficacy of the medication.
  6. Don't call the medicine candy. Emphasize to your child that you are giving him medicine, not a treat. And store all medications out of sight and reach.
  7. If you can't convince your little one to cooperate, let your doctor know he isn't getting the prescribed medication.

Copyright © 1999 Ann Field. Reprinted with permission from the April 1999 issue of Parents magazine.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.