A Spoonful of Sugar, Peanut Butter, or Grape Juice: How to Get Kids to Take Their Medicine

What is it about some kids?

Some kids take their medicine (ok, expect the really disgusting ones) without a peep.  Some even love the taste of medicines and ask for them when they’re not ill at all.  I was one of these strange kids.  Grape-flavored dimetapp was definitely incentive to develop a little sniffle. Most kids seem to struggle a bit but eventually remit.  But some will not ever-ever-ever-under-any-circumstance-even-if-they-feel-horrible-terrible-no-good-very-bad-and-are-old-enough-to-understand-that-the-medicine-will-make-them-feel-better let that icky stuff get anywhere near their mouths.

I have recently been struggling to find a formulation of medicine that will be tolerable to a 5-year-old patient of mine with acid reflux.  Her stomach makes more acid than is necessary to digest her food, and the stomach contents manage to sneak back up into her esophagus, a common problem in adults and also in some children.  However, this is not your garden variety acid reflux.  This stuff is so toxic that the stomach acid sneaks out of the esophagus, scoots over into the trachea and dives down into her lungs where it creates general havoc: inflammation and infection.  She had now had pneumonia six times, each episode requiring several nights in the hospital on oxygen.  A medication that reduces the acid in her stomach can prevent the pneumonia.  Without this medicine, the inflammation can create permanent lung damage.  She needs her medicine.

There is one stumbling block.  My patient, sweet as she is, is also one of those not-ever-ever-ever kids.

Besides trying three different liquid acid-reducing medicines to see if any was more palatable, as well as a chewable tablet, I sent her mother a suggestion list made by some of my colleagues in oncology.  Children who have cancer MUST take their medicine.  That is a no-negotiation situation.  But some of these medicines are pretty dreadful.  And so doctors and nurses and parents must get very creative.

My patient, however, far too smart for all of our good, was having none of it.  In a recent email from her mother, I learned that “she was grossed out by the idea of coating her tongue with peanut butter.”  What to do?  

In the end, thanks to a very skilled–and very patient–nurse that spend hours with her during her last hospitalization, my 6-year-old patient learned to swallow pills, a skill which is very unusual for children under 10 years old.  And now this sweet but stubborn patient of mine stubbornly takes her medicine, with great pride, every day.

 

Tips for Parents:

The bottom line for parents is that sometimes kids need to take their medicines.  It can be a fight or you can give them a little spoonful of sugar (et al) to help it go down easier. Here is a comprehensive list of ways to get your little one to take her medicine.

Some of my favorite on the suggestion list involve first priming the taste buds with a very strong taste, giving the medication, and then following up with the initial strong flavor.  The hope is that the taste buds and brain will be so busy with the first taste that it will ignore entirely the offending substance.  Commonly used foods include peanut butter, frozen grape juice concentrate, and pixie stix.

You can also try to suck the medicine through a straw, bypassing the taste buds altogether.  The child must be relatively coordinated to manage this without backwashing some of the medication towards the tongue.

And finally, this I love, not only for the explicitness of the description but also for 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 milk and eat more Hershey’s kisses.”