Helping the Medicine Go Down

Tips for parents to get their kids to take the drugs they need

SATURDAY, Nov. 15, 2003 (HealthDayNews) -- Spoonfuls of sugar may make the medicine go down in the movies, but at home it's often a different story.

Long before a child learns to read a medicine label, he or she knows what's coming -- and often protests. So, parents frequently find themselves doing battle with their youngsters, coaxing and cajoling them to sit still and take what's good for them.

When they don't cooperate, parents often worry the illness will worsen or spread to the rest of the family -- a legitimate concern as cold and flu season approaches.

But a pediatrician and a pharmacist who've researched ways to make medicine taste better have some useful suggestions. They've developed more than a few strategies to persuade kids to dispense with the drama -- or at least a lot of it.

One of the real keys is adding pleasant-tasting flavors to medicines, says Catherine Tom, a pediatric clinical pharmacist with the Children's Hospital at Montefiore in New York City. A new flavoring technique, marketed in the last few years by a company to hospitals and individual pharmacies, offers more than 40 different flavors, including chocolate, lemon, lime and strawberry.

"The pharmacy usually charges a flavoring fee, a few dollars," Tom says. And, she adds, the company -- FlavoRx -- has done research to make sure that adding the flavor drops won't alter the medication or make it ineffective.

"It's fantastic," Dr. Erin Stucky, a pediatric doctor at Children's Hospital San Diego, and chair of the American Academy of Pediatrics' Committee on Hospital Care, says of the flavoring system. "It's made a phenomenal difference" in compliance.

So ask your pharmacist if he or she can doctor up the medicine. FlavoRx says more than 12,000 individual pharmacies nationwide now use the system, in addition to hospital pharmacies.

If the medicine tastes bad and you didn't get it flavored, you might mix it with food and drink -- but only after consulting with your doctor or pharmacist to be sure you won't alter the effectiveness, Tom says.

If you get the go ahead, Tom suggests that liquid medicine can be blended with syrups such as chocolate, strawberry, or even pancake syrup. Or a cold carbonated drink might mask the taste while the bubbles distract the child.

Some pills can be crushed with a pill crusher, but -- again -- only if you have your doctor's or pharmacist's OK. Then sprinkle the powder on food or mix into a drink. Or put it in applesauce, ice cream or pudding, Tom says.

For really bad-tasting medicine, Tom suggests a "chaser," such as mints or other candy.

"I try different chasers and things to mix them with," she says. "Some medicines that are salty you can't try to sweeten. Sometimes it might be better if you chase salty or bitter medicines with something else that's salty."

If you're trying to cut down on your child's sugary candy intake, Stucky suggests "two or three Cheerios. That way, they'll associate medicine with something desirable."

You might also consider a reward system, Stucky says, such as a ride on your shoulders.

Also important, Stucky says, is the technique you use for giving medicine, especially to small children.

"Ask the pediatrician to demonstrate how to give the medicine," Stucky says. For instance, droppers are good to use for an infant, and administering the medicine to the pouch of the cheek works best.

To encourage cooperation among older children, give them some control. You might ask what they'd like to mix the medicine with, or how they'd like to take it, Tom suggests.

Tom also recommends incorporating medicine taking into your child's daily routine. Suppose medicine must be taken twice a day. Consider giving it before or after tooth brushing.

Also, don't make the common mistake of using the bottle cap or the first soup spoon you find in the kitchen to measure the dose, says Tom. "Using the bottle caps or soup spoons is not a good idea because they vary so much in volume," she says. It's easy to dose the wrong amount.

Invest in a medicinal spoon at the pharmacy, which is clearly marked in either tablespoons, teaspoons or sometimes milliliters or other metric measures, Tom says.

More information

To learn more about giving medicines to children, visit the Council on Family Health and the U.S. Food and Drug Administration.

SOURCES: Erin Stucky, M.D., chair, Committee on Hospital Care, American Academy of Pediatrics, and pediatric hospitalist, Children's Hospital San Diego; Catherine Tom, Pharm.D., pediatric clinical pharmacist, Children's Hospital at Montefiore, New York City
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