Just a spoonful of sugar

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Many new parents - and some experienced ones, too - are uncertain about how to give medicine.

Many new parents (and some experienced ones, too) are uncertain about how to give medicine to babies and young children. The secret is believing that the child needs the medicine. A child can sense any doubts in your mind and will resist no matter what you do, unless you sincerely believe you are doing what is best. Be confident and determined. If you aren't convinced the medicine is necessary, talk to your child's GP first, rather than trying half-heartedly to get it into your child.

If your child hates taking medicine even after you have tried hard and his doctor believes the medication is essential, consult your doctor and your pharmacist. Ask about alternative medications that are less volume per dose, have to be taken less often, and score higher on the taste test. A different form might help - some children manage better with a tablet crushed and hidden in food than with a funny-tasting liquid.

General Tips for Making the Medicine Go Down

Infants

Toddlers and Preschool Children

School-Aged Children

General Tips for Making the Medicine Go Down

 Make sure your child is standing or sitting up at a 45-degree angle when taking any medicine. This reduces the risk of choking.
 Give liquid medicine along the side of the mouth, near the middle of the tongue. If it goes directly to the centre of the palate, it will trigger a gag. Place tablets on the back of the tongue.
 Disguise a medicine's bad taste when possible. Favourite vehicles include apple puree, yoghurt, pudding and jam. For the most resistant cases, try soft pieces of sweets, ice cream or chocolate syrup.
 Mixing a medication with a liquid such as juice, formula or milk can be problematic because a significant part of the medicine will be left coating the cup, glass or bottle. If you use a liquid, use a small amount and make sure all of it gets into the child.
 If you use a spoon, use the measuring type - it's more accurate than ordinary tableware. Better still, use a plastic medicine spoon with dosage markings.
 Never refer to medicine as sweets - you're setting up a potentially dangerous confusion. Tell it like it is.
 Never allow a child younger than a teenager to take his medicine unsupervised for any reason.
 Don't bargain or bribe. The stakes will just escalate. Also, you give the message that taking medicine is a negotiable activity when it really isn't. Give him some choice in the situation - such as what cup he wants to have a drink from afterwards, what room he wants to take his medicine in - but don't imply that anyone has a choice about whether or not to take medicine.
 Don't punish a child who refuses to take medicine. Most medicine tastes nasty and we are all programmed to avoid bitter tastes, which are generally poisons when found in nature. Just insist and plough ahead.

And when the mission has been accomplished, don't forget the BIG hug and congratulations on a job well done - for both of you!

Here are some specific strategies and techniques based on your child's age.

Infants

Hold your baby at a 45-degree angle, with his hands down and head supported. Using a plastic syringe, a medicine dropper or a nipple from a bottle, drip the medicine onto the back of his tongue near the sides. Avoid emptying the dropper into his cheek pouches, because your baby will probably spit it all out at the first opportunity. Also avoid squirting the medicine down into his throat, because your baby might choke. Give him a drink of milk or juice afterwards.

Toddlers and Pre-school Children

You can reduce the bad taste of some liquid medicines in several ways.

 Chill the medicine, then get your child to suck on an ice lolly or small pieces of ice prior to taking the medicine. Then use a favourite cold drink to take the taste away. Cold temperatures numb the taste buds.
 Mix the medicine with a strongly flavoured food such as chocolate pudding. Make sure your child eats all of the mixed food. You can also dilute the medicine in a strong-tasting liquid such as apple juice, as long as your child will drink all of it.

Children aged 1 to 4 are the ones most likely to refuse outright to take medicine. Children that age have strong feelings about what they eat and drink, and are often wary even of things that we think taste good. Listening to your child's feelings about taking medicine before you attempt to give it will often take the edge off strong resistance. If you continue to be firm about the need to take the medicine while continuing to listen, you may be amazed by the cooperation you eventually gain from your child.

As a very last resort, you should hold your child and give the medicine, but this is quite disempowering to a child and listening first will probably work better. If you have another adult with you, one adult can bear-hug the child, holding the arms down and the head at a 45-degree angle. The other adult gives the medicine as described above for infants with a plastic syringe. If you are the only adult at medication time, you can roll your child in a sheet or blanket like a papoose with the arms down, while holding him up at a 45-degree angle, and then give the medicine with a plastic syringe (see above).

Afterwards, praise your child for taking the medicine, but let him know that you will hold him again for the next dose if he refuses. Give him the choice of taking the medicine himself or being held.

School-Aged Children

Children this age can understand why the medicine is necessary and feel more in control of taking it. They can even take medicine themselves while an adult supervises. If your child is reluctant to take medicine, you can use a star chart and reward him for taking a single dose or a day's worth of medicine. If bad-tasting liquids and chewable medication are the problem, see whether your child is ready to swallow pills.

Children can learn to swallow pills starting at age 5, but more typically will master this when they are at junior school, around 7 or 8 years old. To teach this skill, get your child to practise swallowing a small lump of soft food without chewing. Gradually move up to small, hard foods that will dissolve quickly if they get stuck, such as M & Ms or small pieces of ice. When the time comes to take medicine, try small pills whole or large pills cut in half or quartered.

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