Helping your child take medicine (1102)

Children may have a hard time taking medicine because they:

• Do not like the taste. 
• Are afraid of choking or throwing up. 
• Had a bad experience with taking medicine.  
• Want to show they have control.

How can I make taking medicine better for my child? 

• Talk with your child about why the medicine is important.
• Be patient.  
• Be honest. 
• Use simple words as you talk.  Do not speak down to your child. For example, don’t say “You’re too old to not be able to swallow pills.” Or “Your little sibling can do it, so you should too!”
• Let your child know how the medicine will make them feel better.
• Call the medicine by name. Explain what it will do. Don’t call it candy. It might confuse a child and lead to an overdose.
• Do not hide in food or “trick” them into taking it. If the child finds it, they may avoid all foods.  It can also cause mistrust.
• Let your child know ahead of time when they need to take their medicine. Be positive and stay calm. Children know when you are frustrated. This may make it harder for you to succeed.
• Do not put pressure on your child. Allow plenty of time. Practice skills before medicine needs to be taken. Do not ask your child to take the medicine when you are on a strict time limit.  For example, do not give it when you have to leave in a few minutes for school.

Make a plan

 Children do not have control over the fact that they have to take medicine.  It may help to let your child have choices when taking their medicine.

• It’s often easier for children to follow the plan when they helped make it.
• Be creative. Ask your child to help find different ways to take their medicine.
• Practice the plan with your child. 
• Play can be used to help a younger child.  Have your child pretend to give medicine to a favorite stuffed animal or doll.   
• Use a sticker chart for your child to see their success.  Reward both effort and success. Remember, rewards do not have to be physical (like a toy). You may give increased play time, allow your child to stay up a few minutes late, or go to the park. 
• Use distraction like music or a favorite video when it is time to take their medicine.
• Use a timer to help your child keep on track if they are stalling.
• Hold younger children in your lap.  Have your child hold a comfort item like a stuffed animal or blanket.    
Tips for taking medicine
Medicine comes in many forms. These tips may be used to help your child take different kinds of medicine.

Talk with your doctor or pharmacist before trying the tips listed below. Not all medicines can be crushed or cut. Some medicines should not be mixed or taken with certain foods or liquids.

Liquid 

• Ask about FlavorX®. It can be added to some medicines to make them taste better.  
• Use a liquid medicine syringe instead of a medicine cup. 
• Do not squirt medicine from a medicine dropper down the back of a baby’s throat. Put the dropper in the mouth, next to the cheek, and slowly give the medicine. This will help avoid choking.
• Have your child eat something cold like a Popsicle or ice chips before taking medicine.
• Have your child drink juice, suck on a piece of candy, or wipe the tongue with a wet cloth to help take away the after taste.

Crushed/Powder

• If possible, use a pill crusher or crush pill between two spoons.  Some medicine can’t be crushed, it won’t work the way it should.
• Have your child practice swallowing small amounts of soft food (applesauce, pudding, yogurt, Jell-O) without chewing before taking medicine. If they are able to swallow it, mix the crushed medicine with a spoonful of that food.
• Use syrup to dissolve crushed pill.

Pills

• Try gel caps if you have them. They may be easier to swallow.  
• Let your child practice with a new, empty gel cap. Dip it in ice water.  This will make it slippery and easier to swallow.  You can get empty gel caps at a pharmacy or online. 
• Fill a new, empty gel cap with sugar or sprinkles to make it heavier if needed.  (Don’t ever open a gel cap that is already filled with medicine.)
• Some kids swallow pills with a spoonful of soft food (applesauce, pudding, yogurt, Jell-O) instead of liquid.
• You might be able to put some types of pills in ice cream, apple sauce, or other soft food to cover up bad taste or smell.
• Have your child eat something cold like a popsicle or ice chips before taking medicine to numb a sensitive gag reflex.

When is my child ready to swallow pills?

• Can they swallow textured foods without gagging?
• Can they swallow liquids without spilling out of the mouth?
• Consider developmental readiness: can they go to the bathroom by themselves, feed themselves, and follow multi-step directions?
• Check with your health care provider if you are unsure.
Teach your child to swallow pills.
• First, remember that pill swallowing is a skill.  It can be very hard for some people to learn. It can take a lot of practice. 
• Start practicing with candy – smallest to largest
o Cake Sprinkles
o Nerds
o Mini M&M’s
o Tic Tacs
o Regular size M&M’s or Skittles
o Jelly Belly brand jelly beans

• Taking the ‘pill’(candy):
1.  Have your child take a drink or two to wet the throat first.   Use water at room-temperature.
2. Place the candy in the center of the tongue.  
3. Take a big drink of water (not too much!) -- remind your child to keep their head level or looking forward.
o Swallow the pill and water together in one gulp.  
o Take another drink to keep the candy moving.  If it does not go down with the first swallow, calmly tell your child to take another drink and try again. 
• When successful, repeat the step at least three times to build confidence.
• Try to keep practice sessions brief, about 5 to 10 minutes.
• End practice time with your child successfully swallowing a candy, even if that means returning to a smaller size. 
• When your child can swallow a regular M&M, they should be able to swallow most pills.

Other tips
• Try different head positions, like tilting the head back or forward when putting the pill in their mouth. Your child should return to looking forward for the actual swallow.
• Try carbonated, ice-cold, or thicker beverages (like a milkshake). Be sure to follow medical guidelines for medicines that cannot be taken with certain drinks or foods.
• Try different cups. Drink from a bottle or use a straw.
• Give your child some privacy.  Some children cannot learn to swallow pills with an “audience.” You may also practice together.
• Try pill-swallowing aids, like the Oralflo™ cup, Ezy Dose® Medi-Spout™, or a pill glide spray (ask your pharmacist).
• Talk to your child’s mental health provider for help.

What do I do when tips and tricks do not work?

You may have tried everything without success. Your child may still struggle to take medicine.  If your child is upset, take a break before trying to give the medicine again. This may help to calm them down.  Relax with deep breaths.
• Taking medicine is not a choice, but is hard for some children. Be kind yet firm. Tell them that you know it is a hard thing to do and you hope it will get easier.
• Ignore negative behaviors like whining or complaining.
• You may need another adult to help you. Your child can sit on their lap and they can give a ‘hug’ from behind. Have them wrap their arms around your child and hold their arms and head.
• If your child will not open their mouth, press down on their chin. 
• If your child tries to spit it out, hold their cheeks together.
• Help your child keep their mouth closed until the medicine is swallowed. This works best if your child is sitting upright, keeping the head as straight as possible.
• Always try to end on a positive note.  Offer detailed praise like “You worked really hard to keep your mouth closed this time!” instead of a general “good job”, especially when taking the medicine was difficult. 

(Reference: Pediatric Oncology Resource Center, “How to Get Kids to Take….Pills!”)