Trying to give medication to unwilling children at any age can be very challenging and frustrating. Tips for administering medication to children vary according to the type of medication and the age of the child.
For infants, two people may make the task of administering medication easier. One person gives the medication while the other holds the infant, who may be wrapped in a blanket to prevent fidgeting.
Pointers for getting a young child to take medication may include improving the taste of the medication by refrigerating it or adding juice or flavorings, and pretending to give the medication to a stuffed animal or doll before giving it to the child.
Allowing older children a certain amount of control, such as permitting them to hold the spoon while taking a liquid medication, may be an effective way of getting them to take needed medications. If an older child reports trouble swallowing a medication in capsule or tablet form, parents may speak with the child’s physician about crushing the medication and mixing it with soft food (e.g., applesauce).
Adolescents typically recognize the importance of taking medications. However, some may refuse to take them at some point over the course of their treatment. Parents can combat such resistance by reminding adolescents that tending to their health demonstrates trustworthiness and maturity. Parents can also encourage such behavior by granting adult-like privileges when medication regimens are followed. Conversely, parents can remind children that neglecting their health demonstrates immaturity and the need for continued medication monitoring.
Infants and medication delivery
The majority of oral medications for infants are available in liquid form. These drugs often include a sweet flavor to make them more palatable to youngsters.
Infants should be given medication with a syringe, dropper or calibrated spoon because they are not yet able to drink from a cylindrical dosing spoon (which resembles a long test tube with a small spoon at the top) or cup, and regular silverware spoons are not consistent in size. These devices, which may be packaged with the medication, allow a parent or caregiver to squirt, drop or carefully spoon the medication into the baby’s mouth.
Syringes, which are also handy for storing a dose of medication to be used at a later time (e.g., by a babysitter) are available in two forms: oral and hypodermic. Oral syringes are intended to be used to distribute medications by mouth in liquid form. Hypodermic syringes may also be used for this purpose, but parents or caregivers must be sure to remove any needles from the syringes beforehand. It is also important to note that many oral syringes include caps which, according to reports from the Food and Drug Administration (FDA), may be a choking hazard for infants. Therefore, parents may want to discard these caps (if they do not plan on using them in the future) or store them out of reach of children.
Tips for administering oral medication to infants include:
The parent should hold the infant in the crook of their arm and open the infant’s mouth gently by pulling down on the chin. If the infant is especially fidgety and no other adults are available to provide assistance, the infant may be placed on a safe, flat surface such as a bed or changing table.
The parent should place the dropper or syringe in the corner of the infant’s mouth and discharge the medication. They should attempt to slowly squirt the medication on the inside of the infant’s cheek, which does not contain the bitter taste buds found on the back of the baby’s tongue. If using a calibrated spoon, the parent should place the spoon on the infant’s lower lip and then lift the spoon, allowing the medication to stream into the infant’s mouth.
Additional tips for providing oral medication to infants include:
Ask a family member or friend to hold the infant while administering the medicine.
Wrap the infant in a blanket to prevent the child from fidgeting while administering the medicine.
Administer the medication as quickly as possible because infants have short attention spans.
Blow gently (as if blowing out a candle) into the child’s face, which should trigger a swallow reflex.
If the infant spits out all of the medication, start the process again and hold the mouth closed by applying gentle pressure until the infant swallows.
Administer the medication in several smaller doses with a medicine dropper. Careful calculation of dose is important to ensure the infant receives the recommended amount.
Speak to the baby in a soothing tone while administering the medicine. Although they cannot understand words, a calm tone of voice may help put infants at ease.
Contact the pediatrician if the infant vomits within 20 minutes of receiving the medication because another dose may be necessary.
Infants may also require other types of medications, such as eye, nose and ear drops. Tips for administering these include:
Eyedrops:
Hold the infant still. Ask another adult for assistance, if possible.
Pull the eyelid down gently and allow the drops to fall between the lower lid and eye.
Tilt the child’s head back so leftover drops do not stream down the cheek or into the opposite eye.
Nose drops:
Hold the infant still. Ask another adult for assistance, if possible.
Slightly tilt the head back and distribute the proper amount of drops – two or three at a time – into each nostril.
Ear drops:
Position the infant on his or her side with the unaffected ear down.
Hold the infant still and distribute the proper amount of drops into the affected ear.
Wait until the medication has streamed down into the ear canal.
Gently push at the tiny bump of cartilage that lies in front of the ear (tragus) several times to help guide the medication down into the infant’s ear canal.
Young children and medication delivery
Like infants, many of the medications for young children are available in liquid form. There are a variety of techniques for administering medication to young children. They include:
Droppers. These devices are safe and relatively simple to use with children who are not old enough to drink medication from a cup. The parent or caregiver should measure the medication at eye level and administer it quickly as droppers have a tendency to drip.
Cylindrical dosing spoons. These devices are best suited for children who are able to drink medication from a cup but have a tendency to spill. They resemble a long test tube with a small spoon at the top. Children are able to grip the stem easily and the spoon easily fits inside their mouths.
Dosage cups. These devices are best suited for older children who can drink from a cup without accidentally spilling its contents. The parent should place the dosage cup on a flat surface, such as a counter, and measure the medication at eye level. Special care must be taken to ensure the correct dosage is administered to the child. This can be done by carefully checking the numbers on the side of the cup.
Unlike infants, young children may refuse to allow parents to give them medications. Tips to get children to agree to take needed medications include:
Explain the purpose of the medication. Young children in particular do not always understand that medication is intended to make them well. Parents can explain this to children with statements such as “You didn’t throw up once yesterday. That’s because you let me give you the medicine.” Parents may also point out that the sooner the child takes the medication, the sooner they will be able to engage in pleasurable activities (e.g., dance class, a friend’s birthday party) again.
Improve the taste of the medication. Refrigerating liquid medications sometimes makes them taste more pleasant. In addition, flavorings or juice can often be added to a medication. For example, bad-tasting medication can often be masked with orange or grape juice, and many pharmacies will now mix flavorings, such as grape and bubble gum, into medications for a small fee. It is important to note that parents should always seek a physician’s approval before refrigerating medications or diluting them with juice or other flavorings as this can sometimes alter a medication’s effectiveness. In some instances, physicians will suggest that medications can be mixed with a small amount of food. When medication is mixed with food it is important for the child to eat the entire amount.
Numb the child’s taste buds. This can sometimes be achieved by giving the child a frozen food, such as a popsicle, before administering the medication.
Administer medications consistently. Giving a child their medication at the same time and location (e.g., the kitchen) each day helps establish a routine. Parents can even post a medication checklist in the location where medication is administered (e.g., on the refrigerator) and let the child place a sticker or check mark on the list each time they take their scheduled medication without resistance.
Distract the child. Parents may be able to take their child’s mind off of the medication by giving them their favorite toy to play with. Parents can also pretend to take the medication too or give it to a stuffed animal or doll before giving it to the child. However, it is important that children learn that it is not okay to give the family pet or a younger sibling medication.
Provide the child with choices whenever possible. Even though children cannot negotiate whether to take the medication, they can often make choices such as what type of juice to mix with the medication or whether they want to take their medication before or after their bath. This is especially effective among preschoolers (ages 2 to 5).
Explain that refusing to take the medication has consequences. For example, a parent might take away a child’s television privileges until they agree to take their medication.
Give the child an “out” if they remain resistant. Before revoking a child’s privileges, parents should allow the child to take a short break to physically and mentally regroup. Parents should use this time to give their child a glass of water or a hug before offering them the medication once again. Experts recommend that the break not exceed five minutes in duration.
Turn the child over to another adult. When children are especially resistant to taking medication, parents or caregivers may benefit from taking turns doling out the medication. This provides one person with a much-needed break and helps the child to realize that more than one person is capable of giving them their medication.
Praise the child after each dose.
It is important to note that parents should never physically force (e.g., hold the child down) a child to take their medication. Parents who find themselves doing so should seek professional advice for delivering medication from a physician, nurse or social worker.
Older children and adolescents
Older children (ages 5 to 11 years) are typically able to understand the importance of taking prescribed medications. For example, a school-aged child with type 1 diabetes will usually be able to comprehend that insulin is necessary in order to control glucose (blood sugar) levels.
Engaging a child in their own treatment plan allows them to assume some responsibility for their own health. Parents or caregivers may also ask children about ways in which they can help make taking medication easier or more pleasant. For example, children age 6 and older can generally start taking medication in pill form. If a child reports trouble swallowing a capsule or tablet medication, parents may consult with the child’s physician about other possibilities such as crushing the medication and mixing it with soft food (e.g., applesauce). It is important to note that parents should never crush medications without first consulting a physician because doing so may alter the medication’s effectiveness.
If older children refuse to take their medication, parents should allow them to take a short break before offering them the medication again. Parents can also allow older children to exert a certain amount of control, such as permitting them to hold the spoon while taking a liquid medication. Offering the child a reward, such as extending their bed time by 15 minutes, may also be effective.
Many older children are aware of medication side effects, so parents should discuss them openly and provide the child with reassurance when necessary. If parents need additional assistance, they can arrange a meeting with the child and the child’s physician.
Adolescents are also able to understand the importance of taking prescribed medications. However, parents of preteens and teenagers may also be met with resistance when medications are necessary. Even though adolescents are able to recognize that medications will improve their health and well-being, some will refuse to take them at some point over the course of their treatment. This is because teenagers – generally healthy or otherwise - tend to have a sense of immortality.
Parents can combat such resistance by reminding adolescents that tending to their health demonstrates trustworthiness and maturity and that such behavior will result in adult-like privileges. Conversely, parents can remind children that neglecting their health demonstrates immaturity and an adult monitoring them is necessary. However, it is important that parents do not threaten children in an attempt to get them to cooperate. For example, parents should avoid making statements such as “You’re not allowed to go to the mall because you didn’t take your medication.” The use of threats may prompt the child to become rebellious or uncooperative. Instead, making more positive statements such as “I can see that you’re not ready to take your medication on your own,” and following such statements with a consequence can be effective in motivating teenagers.
Questions for your doctor
Preparing questions in advance can help parents have more meaningful discussions with physicians regarding their child’s conditions. Parents may wish to ask their child’s doctor the following questions related to medication delivery:
How necessary is it that my child take this medication?
How can I prevent my infant from spitting up this medication?
What should I do if my young child refuses to take this medication?
What should I do if my older child refuses to take this medication?
What should I do if my adolescent refuses to take this medication?
My child seems to dislike this medication. Is there another medication that may be more tolerable that serves the same purpose?
Can juice or flavoring be added to my child’s medication to make it taste better?
Can my child’s medication be crushed and mixed with food?
Can my child’s medication be refrigerated to improve the taste?
What are some of the things that I should avoid saying or doing when trying to convince my child to take this medication?
