How to Encourage a Child to Take Medicine

 Many times a child will not take medicine because it tastes bad, makes him feel sick to his stomach or because he may be afraid of choking or throwing up.  A child also may refuse because it is one of the few things that he can control when he is sick or for the attention he may gain from caregivers.  The child may also have oral motor problems, an active gag reflex, or a bad experience with taking medicine in the past.

 

General Principles

 

It takes time and patience for a child to learn a new skill.  Remain calm and help your child remain calm.

 

Be honest. 

 

Never refer to medicine as candy. 

 

Children learn best when they succeed.  Praise your child often for even a small success.

 

All caregivers should use the same approach each time the child needs to take medicine.

 

Use positive self-talk (Have your child say aloud what a good job he did).

 

Recognize when you are getting frustrated.

• Step back, take a moment to yourself, and take a deep breath.
• Bring in a neutral party (ask another person for help).
• Seek help from professionals (Health Psychologist, Child Life Specialist, Speech Therapist, Nurse)

 

Make it fun!

 

Helpful Hints

 

• Provide only a couple of choices in how the child can take his medicine.  You might say, “Would you like to take it with juice or water?”

 

• When possible offer a choice about the form of medicine (gel capsule, pill, liquid, syringe).

 

• Crush and mix pills in a small amount of something flavored.  Check with your pharmacist.  Not all pills can be crushed or taken with food.
  • If child agrees, you can mix it in a food that he likes.  Some suggestion are applesauce, juice, ice cream with chocolate syrup, jelly, softened Starburst® candy, Italian ices, Jello®, mashed potatoes.  
  • Flavor-X® which can be added to some liquid medicines allows the child to choose the taste of his medicine.
  • Magic Shell® is a chocolate topping which can be bought in most grocery stores.
  • Swallow Aid® is a gel which can be put on a spoon with a pill to help it slide down more easily.

 

• To help numb the taste buds, have your child suck on a Popsicle® before taking medicine.

 

• Have your child try holding a stick of gum or peppermint candy under his nose while taking the medicine, as smell sometimes adds to the bad taste.

 

• Pinch the child’s nose to block the bad smell.

 

• Have your child take a sip of a favorite drink or a bite of food quickly to change the flavor in his mouth.  Strong flavored candies such as mints work quite well.

 

• Use a timer when structure or a time limit is needed.

 

• Create a reward program.

 

• Use distraction.  You might want to try having your child watch a favorite video before giving him medicine.

 

• Model taking pills through play with dolls or puppets

 

• Teach your child to use relaxation techniques to lessen anxiety.
  • Progressive muscle relaxation
  • Deep breathing
  • Imagery

 

Hints for Pills

 

Remember pill swallowing is a skill that almost anyone can learn – just like riding a bike or tying shoes.

 

Practice pill swallowing during neutral, low-stress times.

 

Use mini M&M®s, Nerds®, cake decorating stars, Tic-Tacs®, Skittles® cut into successively larger bits, increasing sizes of bread rolled into balls to help your child practice swallowing pills.

 

Slowly increase the size of the training aid as the child is able to swallow it.  Limit the size of the training aid to the same size as the target pill to avoid choking.

 

When you move on to empty gel capsules (from a pharmacy), use the smallest one that will work and fill it with sugar or cornstarch to give it some weight.  Empty ones are hard to swallow.

 

Do not practice with soda, as the carbonation fills up the stomach quickly.  Juice is fine, but water is best.  Limit the amount of fluid you put in front of the child to 2-3 ounces at first.

 

Larger tablets may be cut and put into easy-to-swallow empty gel caps.  Check with pharmacist. 

 

What to avoid

 

• Threats (“We cannot go home until you...”, “If you don’t, then...”).
• Forcing against child’s will.
• Bribing.
• Ridiculing or making child feel like he has failed.
• Punishment.
• Power struggles.
• Hiding medicine in food without child’s knowledge, as trust is so important for children, especially when they are sick.
• Setting limits and not following through.
• Pressure which can increase a child’s anxiety, as well as their need for control.
• Giving more support than the child really needs.  If you’re sure the child is able to comply with taking medicine without great distress, don’t let the child get away with not taking it.  In such cases, the child should not be allowed any fun activities until the medicine is swallowed.
• Letting the child to skip a dose can create a pattern of future refusals.
• Ending on failure.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 11/11/2011

Copyright © 07/29/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6453

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