Tip for Masking Medication Taste

 

Does your child refuse to take medicine?  Have you been sent home with a completely unpalatable concoction?  In a previous post I wrote about a patient who refuses her medicine.  I gave her mother this photocopied and pencil-annotated list, which is rumored to have been created by someone on the pediatric hematology-oncology service at University of California, San Francisco (UCSF). I added some personal commentary, just for fun. Many thanks to its authors for the original ideas.

Coat the tongue with a strong tasting substance prior to administration, and then follow the dose with a “chaser” of the same:

SWEET:

• Frozen juice concentrate (grape works best but orange, fruit punch, or lemonade will do nicely)
• Peanut butter
• Toothpaste (but isn’t it already hard enough to get children to brush their teeth?)
• Chocolate or strawberry syrup
• Pancake syrup
• Hard candy*
• Licorice
• Honey (only for children >1 year old)**
• Peppermint ice cream
• Chocolate pudding

SALTY:

• Salt
• Potato chips or pickles
• V8 juice

BITTER

• Coffee (Really? Maybe with a lot of sugar but if the kid already doesn’t want to take the bitter medicine…)

 

Eat something strong tasting or cold before the dose:

• Peanut butter sandwich or crackers
• Popsicles
• Pixie stix powdered candy
• Ice chips

 

Other ideas:

• Chew gum before and after taking the dose.
• Use a straw to get the medication as far to the back of the mouth as possible.
• Pinch the nose while swallowing the dose.
• Swish and spit with Magic Mouthwash before the dose.  (“Magic Mouthwash” is a 1:1:1 concoction of liquid Benadryl, Maalox, and lidocaine, a topical analgesic.  It makes the tongue go numb. Weird, huh?  This is only safe for kids old and coordinated enough to swish and spit, as they should not ingest too much lidocaine.  And it is only available by prescription.
• And my personal favorite (if only for the explicitness and the mention of the brand not once but twice):  Eat a Hershey’s kiss and smear the chocolate around the tongue, then shoot the medicine to the back of the throat.  Chase with chocolate mild and eat more Hershey’s kisses.

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*Please only try peanut butter, hard candy and chewing gum with children who are not likely to choke (>3 years old).

**Honey can contain the spores of the bacteria Clostrium botulinum, which causes botulism.  These spores pass right through the intestines of older children and adults but can reactivate and cause botulism in children less than 1 year old.

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