June 22, 2018
One of the top struggles of parenting sick children is giving them yucky tasting medications. As a pediatric nurse practitioner, I’m no stranger to watching a fresh dose of medication get spit right back up. With sick babies, this situation can be extra difficult, because they do not understand that the medication will actually resolve their pain. Unless you got extra lucky with a little one who loves taking their medicine (and those babies are out there!), then this post is for you. I’ll start with a few ground rules for giving medicine to kids, and then I have 10 hacks to help you get kids to take medicine.
If mom or dad say it’s time to take medication, then it’s time to take your medication. Period. I watch way too many parents make the mistake of making medication sound optional to children. Medications can be a life-saving intervention, and we need to teach children this.
Don’t ask questions like, “Do you want to take your medication now?” Instead, give options when you are able to, like, “Would you like to have your medication mixed with applesauce or yogurt now?”
I’ve watched strong willed toddlers end up in the hospital on IV medications just because parents wouldn’t make them take their medications. Trust me, injected medications, IV medications, and hospital stays lead to a lot of unnecessary pain and heartache. This can be prevented if you start with a non-negotiable policy from the beginning.
I hear this request from parents quite frequently, and I understand the appeal of a one-and-done shot that is over is a few minutes versus a liquid medication that usually takes two doses for 7-10 days. BUT, this truly isn’t an option in most cases. Injectable medications are usually reserved for use in children when other medications have failed.
For example, Rocephin (Ceftriaxone) is a strong antibiotic frequently used in children when other antibiotics (like Amoxicillin or Augmentin) haven’t worked. Because these injected medications can be stronger than their liquid counterparts, they frequently have more side effects (not to mention that shots hurt!). Rocephin is painful enough that most providers will mix it with lidocaine just to try and eliminate some of the pain. Furthermore, if you jump to an injected antibiotic before trying liquid antibiotics, your child will be at a higher risk for developing antibiotic resistance. That is why most pediatric providers simply won’t do it.
When we prescribe liquid medications, it’s because we believe it is in the best interest of your child. I try to remind parents that taking medications by mouth is an activity every person will have to do at some point. Trying to push off liquid medications in your child’s younger years doesn’t work. It usually just makes for a more difficult battle when that day eventually comes.
If your child is small enough that they need a parent to administer a medication, your equipment matters. Medication syringes are easier and far more accurate than medicine cups when giving child medication. In fact, in a study in 2016, researchers found that the odds of making a dosing error were more than 4 times higher using cups than they were with syringes. If you don’t have an easy to read medication syringe at home, I highly recommend this one. It’s a must-have in your medicine cabinet!
Make sure you aren’t using spoons from your kitchen for medications. Spoons are for food only – they are notorious for leading to dosing errors.
Bottle nipples can help young babies take medicine. The act of sucking on a bottle nipple is soothing for infants, so you can measure the correct dose of medication in a syringe and then squirt it into a bottle nipple. Allow your baby to suck on the nipple until all the medication is gone!
In young children, medication dosing is always based on your child’s weight. It’s very important to have an accurate, up-to-date weight for your child before giving medications. If you don’t understand the dosage on their prescription, don’t be shy! Be sure to ask your pediatric provider or pharmacist to clarify. Do you need the weight-based dose of children’s Tylenol, Advil or Benadryl? Snag my pediatric dosage charts!
If your child is small enough that they need a parent to administer a medication, your technique matters. Sit with your child in an upright position (on your lap or in a high chair is helpful). Using a comfort hold position may also help your child with this process. If your infant or toddler is trying to push the medication away with his hands, sometimes swaddling your infant or toddler is a helpful technique as well.
When using a medication syringe, put the syringe toward the back of the cheek and start slowly squirting. Try not to aim for the throat. Often this causes gagging and chocking and parents end up wearing more medication than their child ends up taking! Also, don’t put the syringe near the front of the mouth by the lips, as most children will drool or push the medication out with their tongue. The back of their cheek is your target!
There’s nothing wrong with offering your child a small treat or incentive after taking their medicine as instructed. I don’t love bribery (because, remember, medications are a non-negotiable!), but something as simple as a child taking their medication after dinner and being rewarded with dessert or a popsicle can create a culture of positivity when medication is needed.
If you dread medication time, your child will, too. Something as simple as approaching medication with happiness can help everyone involved! When your little one is a baby, use the same tone of voice for medicine as you would for a treat or something they love. As children get older, you can acknowledge that medication doesn’t always taste good, but it’s critical to help them feel better.
Now, it’s time for the pediatric medication hacks!
This may seem like a no-brainer, but many pharmacies do NOT flavor medications automatically. This can come as an undesired surprise to both parents and children alike when the highly anticipated “bubblegum” medicine is discovered to be nothing of the sort.
Before going home from the pharmacy with your child’s liquid medication, specifically ask if they flavored the medication. Additionally, some pharmacies have a few flavors to choose from (bubblegum, cherry, grape, etc.). If one type of flavor just isn’t working out, ask if you can switch it out and try something different. Different pharmacies sometimes carry different flavors, so you can always call around and check on flavors before sending your child’s prescription in. You can even ask pharmacies to double the amount of flavor in many cases.
Can you mix liquid medications with juice or formula? Yes, but please avoid this common mistake: don’t mix medication with a large amount of fluid. If you put medication in a full sippy cup or bottle, your child has to drink the entire thing to get the full dose of medication. Also, medications should be finished right after they are mixed in your child’s sippy or bottle. This can be hard to do if it is a large amount to drink.
If you are mixing your child’s medication in a sippy cup or bottle, I recommend mixing it with no more than about 3-4 oz of fluid so the full amount of medication can be taken in a short amount of time.
Medicine almost always tastes better when it is cold! The simple act of chilling a liquid medication in the refrigerator can make it much more palatable. Unless your medication specifically instructs you to store it at room temperature, it should be fine to be cooled.
If your child is older than 6 months, they can take either Tylenol or Advil. These medications are some of the most commonly consumed medications in pediatrics. Now, it is very important to follow the dosing guidelines (Tylenol should not be given more than every 4 hours and Advil should not be given more than every 6 hours), but if your child really can’t stand the taste of one of them, you could try the other.
Both Tylenol and Advil help children with pain and fever, so they typically accomplish the same thing. Both of these medications come in a variety of flavors (cherry, grape, blueberry…), so you could always try a different flavor as well! Advil should not be given to infants under the age of 6 months, so Tylenol is the only option for those little ones!
This is the classic go-to trick! Adding a teaspoon of chocolate syrup to liquid medications is very good at disguising bad tastes. This is a very sugary solution, so I don’t recommend this for infants under the age of 1.
Kiddo isn’t a chocolate fan? Honey is good at disguising the taste of medication as well. But, be sure not to give honey to children under the age of 1 due to the risk of botulism.
This is a new trending favorite! Unlike chocolate syrup, coffee cream is a little lighter and comes in a million different flavors. Allowing your child to pick out the flavor gives them more control over the situation and usually helps immensely.
Washing down the yucky flavor as soon as your child swallows the medicine is always helpful!
Most liquid medications are available in chewables and tablets. If the liquid medication just isn’t working, you could request a different form of the medication. This is especially helpful for children who are vomiting. Many (but not all) tablets can be crushed and mixed into a small amount of food (like applesauce or yogurt). Check with your pediatric provider first to make sure it’s okay to crush the medication.
Feeling really creative? Or slightly desperate? This recommendation came from one of our nurses in the KidNurse Community. Mix your child’s liquid medication with frozen cool whip and add sprinkles on top! I’ve yet to see a kid turn down this festive, sweet concoction!
Do you have any tricks to get kids to take medicine? Share them in the comments!
And don’t forget to download my pediatric Tylenol, Advil, and Benadryl dosage charts!
Author: Dani Stringer, MSN, CPNP, PMHS – founder of KidNurse and MomNurse Academy