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My 4 year old daughter recently have scarlet fever. It seems antibiotics are non-negociable for it, and since she has great chance of being allergic to Penicillin, there is only one antibiotic she can get. It is not the first time we have to give it to her, and probably not the last time.

Apparently, that medicine tastes really REALLY bad. She cries a lot, panics every time we say it's time for this medicine, and vomit it most of the time, resulting in even more medicine being force into her mouth.

It is only this medicine that causes problem. She does not tantrum for other medicine, and most of them, she can take the dose we give her all by herself.

We tried reassuring her, explaining why it is mandatory to get it, explaining it will make the scarlet fever go away. We tried mixing it into other food (which seems clearly worse, taste-wise). We tried asking her to take her herself. It seems we tried everything, and the only thing that achieve it for the moment is actually forcing it into her.

We really do not want to force her in any way. Her mother cried yesterday because we had to force her, and we need to do it twice a day. It is very exhausting, and we would welcome any input or new ideas on how to give her this really bad tasting medicine to her.

EDIT : For clarification, it is a liquid medicine that is administrated with a syringe. It seems there are no alternative, although we will check with the doctor again (particularly if pills are available)

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    Just for clarification: The medicine is liquid and you are giving it to her on a spoon? – Stephie Feb 10 '15 at 9:58
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    have you talked to her doctor to make sure that the vomiting is not a counter-indication to using that medication again? panic attacks could cause vomiting yes, but allergy or intolerance to the ingredients should be ruled out as well. – Jessica Brown Feb 11 '15 at 19:57
  • Thanks for the advice, I will try most of those techniques (except point 3), of course :p) – DainDwarf Feb 12 '15 at 8:03
  • I had exactly that problem at about that age. The doctor suggested trying capsules instead. End of problem. – Paul Johnson Jun 1 '15 at 21:03
  • Is it pills/capsules or liquid? (There's also a question around about how to teach kids to swallow pills, is why I ask...) – Acire Jul 22 '15 at 16:29
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I'm lacking a bit of information, so I'l write an extended answer.

When a child has trouble with a really bad tasting liquid medicine you could try various approaches:


1. Avoidance

Of course you can't avoid taking necessary antibiotics. But check with your doctor:

  • Are there other manufacturers that supply the same active ingredient, but with a different taste? I's not necessarily the active ingredient that tastes horrible, sometimes it's the flavorings or the combination thereof.
  • Does the medicine come in a different form? Pills perhaps? Sometimes the adult-sized pills can be halved (if not coated with a time-release agent) or come in a suitable dosage. If yes, see this question on how to make swallowing easier. Your daughter might be willing to try swallowing even comparatively large pills to avoid the taste of liquid medicine.


2. Technique

  • Usually liquid medicine is measured and adminstered by a (special) spoon. We have switched to a trick I learned when I stayed with my child in hospital: Syringes (without needles!) are cheap and can easily be used for measuring. They are spill-proof and can even be pre-filled for later use. You can rinse them out and re-use multiple times (But dump them after one bout of sickness, just to be sure.)
    If placed on top of the tongue, rather towards the back of the mouth - but not too far to prevent gagging, of course - they can be emptied into the mouth and the content swallowed without reaching the entire mouth. With a bit of practise, your daughter might be able to push the plunger and swallow almost simultaneously. Follow with a glass of whatever-tastes-good and you might be rid of most of the nasty taste.

  • Chilling the medicine (if permitted, see leaflet or ask your doctor/pharmacy) might also reduce the intensity of the percieved taste.


3. Distraction

  • No child likes to take medicine, especially if it tastes "bleach...". And sick children are sometimes cranky and non-cooperative even without medicine. So kudos to your normally well-behaved daughter! But in this case, I'd suggest distracting your child when it's time for the medicine. Who says it can't be taken while watching a favourite cartoon or TV show? Most children will be taking their medicine without much fuss just to be able to continue watching. Might work with other methods too, as long as they are engrossed enough. Telling a really fascinating story, perhaps? Asking riddles? Whatever makes for a rapt audience is fine with me. And they deserve a bit of extra pampering anyway...
  • Thanks for the detailed and useful answer. However 1) Since it is not penicillin, it seems there is only that (liquid) medicine. I guess we'll double check with the doctor, as we did not ask our doctor directly (her father asked, I'm the step-father) 2) We are already using a syringe, as this medicine comes with one. It does deliver the medicine, but it takes much effort and forcing. 3) Already tried, but that does not work. Distraction works however for the aftermath, when she already have gotten the medicine and try to forget the taste, and we pray that she will not vomit it. – DainDwarf Feb 10 '15 at 13:02
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    Did you try the "syringe really far into the mouth" thing? Perhaps she would be willing to practise with juice just to see how this method really prevents tasting much? Just don't say that she will taste nothing, but that it's less. Might help overcome her resistance with the real deal? – Stephie Feb 10 '15 at 13:35
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One method I would suggest is dulling the child's sense of taste.

There are a few methods you can take to try and do this. From personal experience, these efficacy of each method tends to vary based on the exact nature of the foul substance to be ingested.

  • Have them suck on a sugar-free candy in advance of taking the medicine. The artificial sweeteners in sugar-free candy have an effect of telling the brain that something sweet, like sugar, is being consumed, and this effect may persist for a short time after consumption. Also, the candy itself may coat the mouth as it dissolves, acting as a sort of protective barrier against the incoming medicine.
  • Have them pinch their nose while taking the medicine. Taste and smell are closely-linked senses, and dulling your sense of smell may dull your sense of taste. However, my anecdotal experience is that pinching the nose allows only the strongest flavors to come through, and foul-tasting medicine would qualify as strong.
  • Drink or eat something sweet that coats the mouth and the tongue, such as chocolate milk or honey. Like the candy, this may coat the mouth and tongue with a protective barrier that prevents the medicine from interacting with the tongue's taste receptors.

For candies or sweet things, I would also suggest trying some very strong mints, if your child likes them (mine loves them). The mint smell can overpower your scent receptors, and the flavor may do the same for your tongue.

A word of advice: don't give the medicine if the child has recently brushed their teeth. Science suggests a chemical in toothpaste (and a variety of other products), called Sodium Lauryl Sulfate (SLS) dulls the sweet receptors of your tongue, which is why it makes orange juice taste bitter. This would make the medicine taste even worse.

Also, be careful about long-term use of foods to mask foul tastes. Taste aversion is the strongest form of conditioning, and associating certain foods with the medicine may cause conditioning. For instance, my wife used to have to take certain medicines my crushing them and mixing them with pudding or apple sauce. For several years afterwards she could not eat chocolate pudding, even if she wanted to, because of taste aversion.

3

My son is 2.5-years-old, but has had to take allergy medication for quite some time. While most of the medicines have some sort of sweetness added to them, they're still not a pleasant experience. Although, he's had various other prescriptions (antibiotics) that aren't as pleasant as the allergy medicines.

My solution may not work for you, as my son has to take medication daily, and not just for a short-term prescription.

  1. Use a medicinal syringe, and not a spoon. If one isn't provided, many pharmacies will provide them at no-cost. They can also provide toppers for the medicine bottle, so that you can use the syringe easily.

  2. Bribe them with a treat. "If you take this medicine, you can have some candy." Candy is okay to give to children in moderation. It can help them maintain their blood sugar, and children's bodies are hard-wired to react positively to sources of sugar, and it may help their bones grow.

  3. Tell them that if they take the medicine nicely, they can have extra candy. "If you take it without finding, you can have two pieces!"

  4. Be determined to make the child take the medicine. You don't have to hold the child's nose to make them open their mouth. By using the medicinal syringe, you can push the tip of the syringe between their lips. I find that the corners of the mouth work best. Then, you can push the the liquid in, even if their mouth isn't open. It is not torture to give your child medicine that they need, even if you have to hold them down. Your child is simply not old enough to understand that the medicine is better for them in the long run. They only know that in the immediate now, it tastes unpleasant. One of the few ways young children have to communicate with adults is by crying, screaming, throwing tantrums, etc. It doesn't necessarily mean they're actually in pain or being traumatized, it just means that they're escalating through their available methods of communication.

  5. Even if you made the child take the medicine, by forcing the syringe in, give them the candy you promised.

  6. Eventually, the reward of candy will be associated with taking the medicine. For us, it did not take very long.

This seems very straight forward, but we also made additional choices to smooth the process along.

Give control to your child. For my son, we gave him a variety of candies to choose from (I think we had left overs from some holidays. We don't normally by candy.) If we let him choose which candy he wanted before he took the medicine, he was more willing to take the medicine.

You can let the child pick out their "medicine candy" from the store. Have them pick a bag of something you're okay with, and emphasize that it's their candy for after they take their medicine.

We also gradually allowed him to take the medicine himself. He has always been very independent, and so it was easy for use to start allowing him to take the syringe and push the plunger in himself. He did make a mess a small number of times, usually by pushing it in too fast, but he learned to control that quickly, as well. You can prevent some messes by splitting up the dose, so your child doesn't have so much to "spill" at once.

The candy doesn't have to be big, or even candy! My son really likes jelly beans (we had the Starburst kind from Easter). We'd give him two of those tiny jelly beans and he'd be thrilled. Additionally, sometimes we'd give him his vitamins! He takes chewable gummy vitamins that are essentially candy for him.

Now, we almost never have to administer medicine to my son. We just had him the syringe and he's fine with it. We also don't give him candy every time, since he's so compliant. If he asks, we'll usually oblige, but he often forgets.

The occasions when we do have to force him to take the medicine are when he's really sick. He's feeling unwell, and is generally uncooperative (I don't blame him). But, when's he's on antibiotics it's important that he doesn't miss a dose, and that it's taken on time. For instance, failure to take antibiotics correctly as prescribed can have negative outcomes in the long term, and possibly result in recurring infections.


Not all young children are familiar with candy. It may be a poor incentive if your child doesn't know how good it makes them feel. So, before using it as an incentive you may have to give them a taste for it at a time when medicine isn't involved.

2

Mary Poppins has some good advice for this scenario: "Just a spoonful of sugar helps the medicine go down."

While sugar itself might not be the best option, try mixing the medicine into something sweet. It probably won't entirely disguise the taste, but it should at least mask the taste enough that the experience isn't too traumatic for the child.

Some suggestions:

  • Chocolate pudding
  • Applesauce
  • A spoonful of honey
  • Fruit-flavoured yogurt

Of course, always check with your doctor or pharmacist to be sure that mixing the medicine won't reduce its effectiveness or cause any ill effects.

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I had exactly that problem at about that age. The doctor suggested trying capsules instead. End of problem.

I guess that capsules don't work with young children because they try to chew them, but by 4 years old she is probably old enough to learn to swallow without chewing. Maybe she could try swallowing some tic-tacs (tiny pill-shaped sweets) for practice.

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