Wednesday, July 25, 2012

Getting your child to take medication -- part 2

     Over the years, we have found getting children to take medication is not always easy. And sometimes it takes a major amount of effort! The following are a number of tips to try to help you get your children to take their medicine.
     First, there are some scenarios where it is not necessary for your child to take any medication to get better. Although we as adults may agree that your child would feel better if we got their 102 degree temperature down with a fever-reducer, that their stomach would feel better if they chewed up a chewable antacid for their stomachache after eating spicy food for dinner, or their nose would not run so bad if they would take an allergy medication. However, with these issues, they "will be okay" without taking the medication. Consider in these situations simply not stressing over the medications. One Christmas morning in the Teller household, we had our son vomiting with a fever of 102-103 degrees. He declined any fever-reducer (which stressed out his grandmother) because, in his words, "that will make me puke". So he just laid on a cool tile floor in the bathroom and rode out his fever. If he would have been more lethargic, we would have pushed the issue. It was a 24 hour viral illness and was better the next day.
     There are some instances when it is essential that the child take their medication. There are bacterial infections, such as pneumonia or staph skin infections, when it is very important for the medicine to be taken in full, each dose. In these cases, we worry that a child could end up quite ill and in the hospital if they do not do well taking in their medications.
     One issue with children taking their medication is "issues of control". Even nice children will test their parents. They may think they can refuse to do something their parent wants them to do and exert some control over the situation. Although it does not always work, sometimes these children can be convinced to take the medication with small bribes -- a small treat, a coin to put in their piggy bank, a special privilege. Do not hesitate to say "You will need to take your medicine now." Although giving them a choice (in a dosing cup or in a syringe?) may help, it is best to stay unemotional and matter of fact.
     A common issue is taste of the medication. Sometimes there is more to do about this than others. Thankfully, the pharmacist can often add flavoring (which may really help) to a medication if your child will not like the initial flavor. For better or worse, there is no flavor every child loves. One study showed that the 30% of all children would take even the worst tasting commonly-prescribed antibiotic (Vantin(r)) and only 80% of all children would take the best tasting (cefdinir/Omnicef(r)). With over-the-counter medications, you often have some choice over taste. I think you can assume that name-brands taste better than generics (although not always). Many times with a taste issue, "chasing" the medicine with something to eat or drink (a favorite juice, a lemon-lime soft drink, etc.) may help. Remind your child "As soon as you drink the medicine, you can have your juice".
     We are asked many times whether the medication can be added to something the child regularly drinks -- milk or juice. Keep in mind, you want to add enough beverage to cover the taste, but not so little the child can clearly still taste the medication. Also, if the medication is put into something to drink, they have to drink it to get the dose. If you drink half of the medicine, you probably got half of the dose if you mixed it up well. So proceed cautiously!
     It certainly helps to eliminate issues with the flavor of medication if the child learns to swallow a pill. The average child learns at about 12 years of age, but we see grade-schoolers who can swallow a pill and teenagers who cannot swallow a pill. I try to remind the "big kids" they swallow food pieces much bigger than the pill size. One good way to work up to swallowing pills is to try swallowing small pieces of candy and gradually increase the size of the piece. For instance, if your child can swallow Nerds(r) candies then move on to Tic-Tacs(r). The good news is that if your child fails to swallow it, they can always just chew it up. Reward your child's success with allowing them to have more of (and to eat it normally) the candy they just successfully swallowed.
     I hope this information helps!

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