At some point during his or her childhood, your son or daughter will need to take some type of medication—vitamin D drops for breastfed babies, bubblegum pink amoxicillin for a bout of strep throat, acetaminophen for an occasional fever or prescription drugs to treat chronic conditions. If you’ve ever struggled with getting medicine into your child, you’re not alone.
Appeal to Your Child’s Taste
Dorothy Freas first gave medication to her daughter, Eliza, at 4 months old, when reflux warranted intervention. “It smelled awful, and she would spit it out,” Freas recalls. “We found what worked—alternating drops of medicine between sips of nursing.” Now 8 years old, Eliza has been taking a daily prescription for another common disorder for two years. In the beginning, Freas would open the pill to dump its contents into food, which made the food taste yucky. What trick finally worked? “We’d put it on a small spoonful of ice cream,” says Freas.
Last year, Eliza learned to swallow a pill by following strategies in a short video her mom found on YouTube, posted by the Alberta Children’s Hospital Foundation (search for “The New Method of Swallowing”). “This video saved the day,” says Freas. It came down to needing a systematic way to do it and understanding how head position affects the esophagus. Training techniques included practicing with tiny candies. “It didn’t even take two weeks! That was a game changer for sure,” adds Freas.
Pediatrician Alicia Morgan-Cooper of Village Pediatrics in Baltimore says that struggles with administering medicine can happen at any age, but usually starting at around 6 months. “Developmentally, that is when babies begin to understand cause and effect. They begin to remember things.” Around that time, they start to get stranger anxiety. They’ll recognize a smell, or what a dropper looks like, and they don’t like what’s coming.
For young children, appealing to taste may help. “Pharmacies have flavoring that can be added upon request, if it motivates. But be prepared that the child may not like the flavor,” she adds. Try applesauce, yogurt, pancake syrup or chocolate syrup to camouflage medicine at home if needed.
Knowing how to swallow a pill is helpful for older children. “Usually by 10 years of age—but no pressure. As the child grows, the liquid dosage would increase, so a pill becomes more efficient,” explains Morgan-Cooper. “When I write a prescription for a child younger than 13, I ask if they want liquid or a pill because many kids either can’t or don’t want to swallow pills.”
Use Age-Appropriate Language When Talking to Your Children
If your child is reluctant to take medicine, clear, age-appropriate communication is important. Your pediatrician can help you find the right words to explain to your child why a medicine is needed. “For older toddlers and school-aged kids, reassure them that the medicine will only be given x number of days and mark a countdown on a calendar so that they see something
tangible,” says Morgan-Cooper. “Depending on the age of the child, discuss that, if they are feeling bad, the medicine will help them feel better faster.”
Child psychologist Dr. Cyd Eaton, a research associate faculty member at The Johns Hopkins University School of Medicine, studies medication adherence. If underlying anxiety is presenting a barrier to taking medicine, psychologists can sometimes step in to help with counseling or even pill-swallowing therapy.
To counter unwillingness to take medicine, parents should have honest conversations and keep the tone supportive. “Maintain their trust by being open. Let children ask questions and address their concerns early on,” urges Eaton. “What are the barriers to getting the child to take medicine? Do they not want friends to know? Are they afraid they’ll have to take it forever? Is it the act of swallowing a pill that worries them? Taking a step back makes it easier to see the obstacles.”
Try a Variety of Rewards
Eaton feels the best way to promote adherence is with positive reinforcement, but emphasizes that nontangible rewards are the way to go. “Verbal reinforcement like ‘great job taking your medicine. I’m proud of you!’ goes a long way,” suggests Eaton. “Don’t make rewards disproportionate to what is being asked.” Rewards can be as simple as extra attention and time together for
A sticker chart is a handy way to visually track progress. Using pillboxes can be good for organization and compliance, and to monitor whether a medication was taken as planned. “The most common barrier to medication adherence is actually forgetting to take it,” says Eaton. Build time for taking medicine into an existing routine, such as tooth-brushing time. Set a time that is free from stress and distraction.
“I’ve been there,” Freas says in reassurance to other parents. “Try to be calm. Don’t feed into the kid’s angst. Don’t fight over it. There’s got to be a better way. Try a lot of different strategies. Nothing is too crazy if it works. Ask other parents what has worked for them—but know that all kids are different, too. Ask your pediatrician to help figure out the reason (taking medicine) is hard for your child.”
Eliza heard that her mom was going to talk to this writer about kids who need to take medicine. “Oh, I’m good at that!” she proudly declared, and rightfully so. Mastering the ability to swallow a pill is a developmental milestone achievement, much like potty training or riding a bike. This skill helps her feel more in control of this aspect of her life—and it makes things a whole lot easier for mom, too!
More Ideas to Encourage Medicine Taking
• Place pill in the back of your child’s mouth.
• Have your child swallow the pill with a thick liquid, like a smoothie.
• Crush or split pills; open capsules and place contents in applesauce or yogurt, etc.
Strategies for liquid medication:
• Use a medicine syringe.
• Have child sit up or sit at an angle instead of lying flat.
• Place syringe between teeth or gums.
• Drip medicine slowly toward the cheek, never directly to the back of the throat.
Tips courtesy: Dr. Alicia Morgan-Cooper, Village Pediatrics
• Use nontangible rewards.
• Build taking medicine into routines such as tooth brushing.
Tips courtesy: Dr. Cyd Eaton, The Johns Hopkins University School of Medicine