Friday 31 January 2020

Top tips when your child won't take medicine

When you have a child who is poorly it can be very stressful; when you have a child who won't take any medicine, days can become unbearable. Our youngest daughter has refused medicine from a very young age and I can't deny that it has always been a huge worry. I think we're lucky that she has generally stayed fairly healthy over the years - and yes, I am touching wood right now. Those times when she has been poorly, her body seems to work extra hard in fighting the infection off itself.
faded image of girl lying on bed with text Top tips when your child won't take medicine
Text reads: Top Tips when your child won't take medicine
When she was very young, we tried to give her liquid paracetamol or ibuprofen but anytime we did, she would gag and throw it back up. Very quickly, she began resisting when we even tried and we had such a huge struggle on our hands that we had to give up and look for other ideas. I wrote this post when she was just five, scared because her temperature was rising and I felt helpless as to what I could do for her and worried that she might end up in hospital. I was right to worry, as the following post showed. 

That time when I took her to the doctors to get her chest examined initially (she was often prone to coughs), the young doctor started to explain that he could prescribe antibiotics but they don't really like to because of the risk of the body becoming immune to them. I didn't want the antibiotics anyhow, as I knew I had no chance of getting them in her. 'Medicine is disgusting' - that's her party line, and she's stuck to it. To be fair, a lot of medicines do taste gross. I'm sure I'm not alone in wishing that flavourless medicine would be invented, or a patch to stick on the skin, such as is done with nicotine

When I told the doctor that there was no point in prescribing anything he stopped, looked at me, and asked what I thought I would do if she did ever really need medicine. I replied honestly that I had no idea. Truth be told, I hoped that he, or someone else in the medical profession, would be able to provide that answer!

We still haven't found the answer. Our girl has been in hospital twice, having to have the medicine injected through a cannula. Four years ago, she had to spend ten days in hospital and was eventually diagnosed with Post Streptococcal Glomerulonephritis. We weren't aware that she had any infection in the first place, her body was so good at hiding it. But then her face suddenly became puffy and she was sick - although she was still telling us there was nothing wrong. 

Over the years I've heard several suggestions of how to help children take medicine and so I thought it might help to share them in one post. Please do bear in mind though, that I'm no medical professional and it's always good to ask your doctor or pharmacist for advice. These are just some early stage suggestions which may help.

1. Consider different formats

Obviously when children are young, liquids are the best option for medicine. As the children mature though, it's worth considering alternative forms - pills, melts which dissolve on the tongue, or chewable tablets. Chewable tablets can also be cut in half or quarters and swallowed without chewing too; a bit like pills or tablets which come in a variety of shapes and textures. For pills, some people prefer swallowing caplets, some round tablets, coated or uncoated, whereas others need dissoluble options - I think I was probably well into my thirties before I even realised how many different shapes or coatings there were. What works for you is often the first place to start trying with your child, but that doesn't mean it is going to suit them too.

2. Try it yourself first

Following on from that last point, if you try a medicine yourself and think it has a lovely strawberry taste, it doesn't necessarily follow that your child will think the same. For some children however, the suggestion that a taste is good will be enough to convince them to try. Seeing an adult actually swallow something which the child is expected to take might give a bit of confidence. On the other hand, if the taste really is foul (and let's face it, so many medicines are), then it might give you an indication of how much your child doesn't want it. 

3. Is honesty the best policy?

Usually I'd say yes to the above statement but I think everyone needs to decide for themselves on this when it comes to trying to get your child to take medicine. Hiding, or disguising the medicine may well be the only way you can get it into your child. 

4. Mix liquid medicine in drink or food

Mixing with food or drink is one of the most common ways to try to hide medicine, to make it easier to swallow. First thing to note though, is that it is always worth checking the patient information leaflet which comes with the medicine, and/or asking your pharmacist whether the medicine can be mixed with food. Some medicines may become inactive if mixed with food, or may release slower or faster than intended, and this might even negate the effect of taking them at all. So checking first is the best policy.

Our girl only drinks water and no 'runny' kinds of foods though, so we found this wasn't a possibility for her. I'd also go back to the point above about honesty and trust; if the medicine is particularly strong or foul tasting, you may just be ruining what was for them a much loved food. If you don't explain what you've done, they may not accept that particular food or drink ever again, which is a risk especially if you have a child with a limited diet. Some ideas of ideas to try are:

Spoonful of sugar

Most people will have heard the 'spoonful of sugar' song from Mary Poppins and this is indeed one method you could try. A spoonful of honey for older children (over 12 months) may work, or a spoonful of chocolate spread or melted chocolate could be other options. Mixing the medicine with any kind of drink (smoothie, fruit juice, soda) or food (yoghurt, chocolate pudding, ice cream) could be the answer to making it more palatable.

Crushing tablets

Powdered medicine, either from a tablet crushed with the back of a knife or from a capsule which has been opened, can be sprinkled on toast or added to fries or other favourites, just like salt would be. Powder can also be mixed in thicker liquids fairly easily. Of course the downside of this method is that it would be more difficult to guarantee that all the medicine had been ingested unless you're sure your child will eat all the food given. 

Injecting into food

One of the most ingenious methods I ever saw was the idea of squirting some liquid medicine into the inside of a marshmallow. Wouldn't have worked for our youngest but I reckon our eldest might have fallen for this as marshmallows were a real favourite, and so soft and fluffy to eat. Again worth checking that the medicine taste is not too strong though, or I suspect the marshmallow might not go down... 

Wrap in sweets

This is something I've never done myself so please do be careful if you are going to try this method. The idea I read was to melt a chewy sweet (such as a Starburst) in the microwave for just a couple of seconds, then wrap it around a chewable tablet.

4. Practice swallowing pills

When a child is poorly, they are far more likely to become distressed or resistant to the idea of taking any medicine. It's better to have discussions around medicine at a time when they are alert and well and might be more open to listening about the science behind it. This is also a good time (when they are old enough) to try to get them to swallow without chewing - tic tacs are suggested as a good idea to start with, due to their size. If a child can swallow one of these, they will feel a sense of achievement and hopefully feel less anxious about a tablet when they are ill.

5. Suck through a straw

This is a method which was only recently suggested to me. When I first heard of this, I immediately shrugged it off, thinking of how I personally need to take a big gulp of water in order to be able to swallow a tablet and that a straw only produces a thin stream so would never work. Trying to be open-minded though, I had a go myself and was amazed to find how easily the pill slipped down. I'm guessing it's to do with the direction and force of the water flow - it really did work for me!

7. Ask for suppositories

Not a very common option here in the UK but this did actually work for us for a short period when our girl was younger. I think suppositories are meant to be a good way for the medicine to enter the body's system quicker too.

8. The colder, the better

Ice cream is often suggested as a great incentive or a great tasting food to hide the medicine in. It has the additional advantage of being cold; if taste buds are frozen then it's much more difficult to taste. Along the same lines, using ice lollies to numb the mouth in advance is worth a try, or even diluting the medicine and turning it into small ice lollies. Some medicine may become inactive if frozen though so please do check for any particular medicine.

9. Close eyes, hold nose

Have you ever noticed that you can't taste much when you have a blocked nose? Or that you are less likely to want to eat food which looks like something the dog has brought in?! These two tips might seem way too simple but could actually help a lot - your child may prefer to hold their own nose or to have you help them. Just remember to remind your child to breathe and not hold the nose closed for too long!

I'm not going to give 'pin them down and force them' as advice here because not only did trying this make us feel awful when our girl was younger, it actually didn't help. That said, I'm not judging anyone who goes with this method... as parents and carers, we have to make our own decisions as to what is best for our child. Some medicines might be considered more necessary and more 'life saving' than others. I'm sure many children have had medicine forced down them at a young age and don't now hold that against their parents or carers. I guess my only advice here would be to have the conversation, before and after, and explain what was necessary, even when the child is young and you may not think they can understand.

In summary, if you are finding it difficult to give your child medicine, please don't feel bad. Don't feel alone either - I'm pretty sure there are thousands of parents out there struggling with this same issue right now! All you can do is try your best. Let me know if you have any other ideas...

faded image of girl on bed with text Top tips when your child won't take medicine

To find out more about our experiences, please check out our 'About Us' page. If you are looking for more information on Pathological Demand Avoidance, the posts below may help.

What is PDA (Pathological Demand Avoidance)?

Ten things you need to know about Pathological Demand Avoidance

Does my child have Pathological Demand Avoidance?

The difference between PDA and ODD

Strategies for PDA (Pathological Demand Avoidance)

Pathological Demand Avoidance: Strategies for Schools

Challenging Behaviour and PDA

Is Pathological Demand Avoidance real?

Autism with demand avoidance or Pathological Demand Avoidance?

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  1. My daughter is exactly the same at 8 yrs old. Did this get easier for your daughter as she got older? I am running out of ideas!

    1. Ah. I'd love to tell you it has but she still won't take medicine, sadly! A couple of years ago she did practise swallowing a tic tac and managed that, but she's told me there is no way she would try it with any tablets.... :/

  2. Our 3 year old will not take medicine. She doesn't understand well enough to be persuaded but she's smart enough to know when we're trying to disguise it. I'm out of ideas ☹

    1. Nothing has worked for our girl.... she did once try some chewable nurofen tablets but won't take any more. Maybe it shows that some bodies just don't need it though, except in extreme circumstances?!

  3. Our autistic child has to have medication every day for anxiety and the only way they’ll take it is (knowingly) hidden inside a teaspoonful of Nutella.

    1. Great tip, thank you! This is one of the few foods that our daughter does eat, so I'm going to suggest it tomorrow....

  4. Thank you for writing on this topic. I’m currently struggling with this exact situation with my 3 year old PDA child. I feel totally defeated. I am so worried she will just get sicker and end up in the hospital. It is nice to know we are not alone! Although it would be nice if none of us had to experience it. Thanks again.

    1. It is so difficult, and stressful for us parents! I hope one of the ideas works for you x

  5. discovered this today! my daughter is 30, she still wont take meds. at 23 she got sepsis, and it was only because i noticed her turning grey i knew something was wrong, she had a burst gaul bladder. but even after op she refused to take meds. currently she has , a nearly week long, migraine...she wont take anything and medical professionals are not being very understanding! I really have no way of helping her.

    1. It's so difficult isn't it, and worrying for us as parents :(


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