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Healthy Children

with Steven Parker, MD

This blog is now retired. Dr. P passed away on Monday, April 13, 2009. The WebMD Community will dearly miss his kind, caring, and often humorous manner.

Friday, May 16, 2008

How can I get my child to take medicine?

Q: My daughter refuses to take her medicine. What to do?”

A: As always, before we propose what to do, we need to figure out why the behavior is occurring in the first place. Assuming this is your daughter’s main bone of contention and there aren’t major power struggles in other areas, here’s my educated guess as to what’s going on.

I’m betting that this is an issue of temperament and that your daughter has what’s called a low sensory threshold for some tastes. Some children, for example, are very sensitive to touch, others to sound. Perhaps your daughter happens to be very sensitive to taste. (Interestingly, we’ve learned that some kids and adults are “super-tasters” — people who are very sensitive to tastes because they simply have more taste buds and nerves at the back of their tongue. Super-tasters may grow up to be master chefs or wine stewards, but they can be very challenging as children when you need them to swallow something they’re not used to.)

So first, it may be important to recognize that your child probably is not purposely misbehaving or being spitefully willful. For whatever reason, the stuff probably really does taste yuckier to her.

So now that you understand it, hopefully you’re not going to blame her or demean her for it. That’s great, but, hey, one way or another you still have to get the medicine down her gullet! So here are some tricks of the trade to consider:

  • See if the medicine comes in other, more palatable flavors. Are there chewable tablets she could try?
  • Mix the stuff in with a favored cold food (like ice cream or yogurt) or peanut butter or applesauce or whatever works (make sure the pharmacist OKs this).
  • Encourage her to swallow quickly.
  • Wash the medicine down with a favored cold drink or with chocolate syrup.
  • Have her hold her nose when she takes the medicine and/or drink it through a straw (less smell = less taste).
  • Refrigerate the medicine. It may not taste as bad cold.
  • Have her suck on a Popsicle or something cold to numb her taste buds right before downing the medicine.
  • Try sticker charts and/or bribery for success.
  • Give the medicine by squirting with a medicine syringe (much less likely to spill). In most cases you should allow your child to spritz it in herself so she feels in control. Practice this ahead of time. Occasionally, some children prefer to close their eyes and have you do it.

No matter what strategies you chose, you should have a planned discussion with her about it. (After all, it’s hard to hold a rational discussion when, like The Exorcist, she’s spewing purple liquid at you!) Explain that the next medicine will have to be taken and that’s final. Don’t spend much time explaining why. Ask her how you can help her to make the process easier. Tell her what you’d like to try and be very optimistic about how helpful will be whichever interventions you chose. Some children then do well with a dress rehearsal, using a syringe full of juice.

Be firm, authoritative, and patient about the whole thing. Your daughter needs to know that you’re willing to wait until the cows come home for her to drink the stuff and that you’re not going to bend.

In the absolute worst-case scenario — when nothing has worked — you may need to simply resort to brute strength and superior determination. Use two adults, one to restrain her, the other to administer the medications. If necessary, hold her nose so she is forced to open her mouth. Slowly pour in the medicine. Sometimes blowing in the face triggers the swallowing reflex.

After the ordeal is over, remind her that you are doing it so she will get better and that you don’t really want to have to do it and wouldn’t she like to get with the program? At that point almost all children quite sensibly decide it’s better to comply, as they realize that this is simply a battle they are not going to win. Then you can go back to plan A and find the right tricks to make it easier for her.

Tools to Try

Posted by: Steven Parker MD at 2:51 pm

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