Wednesday, June 19, 2013

Tips for giving medication

PLEASE SEE THE UPDATED POST 2/2017
The compounding options have changed.
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Parents have to pick their battles. Sometimes things really aren’t so important and we don’t have to necessarily get “our way”. Generally though, the medication battle has to be one where we come out on top.
The assumption of course, is that you have decided for a valid reason that your child has a condition that needs to be treated. If this is the case, have firm but loving attitude.  
(Think Mary Poppins and her spoonful of sugar)
Make it clear that you mean business and whether or not they like it, they will be getting the medicine, one way or another.
For your young child, hold them at a 45 degree angle,  If they are flat they can choke a bit, and if they are sitting up too high they can spit.
If they are using their hands to knock the medication away, wrap them in a blanket (think straight jacket)
A syringe is much more effective than a spoon and is better for measuring.
Squirt a small amount in the side of a cheek.
Keep the chin elevated
Give a tiny bit at a time and wait for a swallow in between.
Some of our tough customers are most likely crying and screaming throughout the process. It gets easier.
If you are giving a teaspoonful, that would be 5 ml in a syringe. Giving .5 ml per squirt would mean 10 squirts. This may take several minutes, but the dose will go in.
The only kiddos that can beat this system if you are doing it slowly enough are the ones that learn how to vomit.

Okay, what are your options if you have a vomiter on your hands?
If your child needs antibiotics, sometimes we can give an injection.

If you are simply trying to get in a dose of fever reducers, Acetaminophen  (Tylenol) comes in suppository form that is quite easy to give.

For kids who are old enough to reason, lets give them some choices. What would they like to drink after the medicine? Should we have the pharmacy add a flavor?
Sometimes holding a lollipop and taking a lick after each squirt helps with a bitter taste.
Some of the generic antibiotics are truly vile. Azithromicin (Generic for Zithromax) is one of the worst. The name brand is significantly easier to get down, but most insurance companies won’t cover it without an enormous co-pay)


Do some  role play ahead of time.
Have one cooperative stuffed animal one stuffed animal (or doll) who kicks a fit.
For the cooperative doll say things like, “ I know this tastes a little yucky, but it is really important and it will help make you feel better. I am really proud of you for being so cooperative."

Let them be the parent who has to give the medicine to the uncooperative doll.

Choices and rewards are fine, but make it clear from the get go that the discussion will last 5 minutes and no more (set a timer) when the timer is up they will be given the medicine the same way a baby gets it, with no choices involved. When the kids realize you mean business they cave fairly quickly.
One reward method is to make it possible to earn 10 pennies per dose. Put the money on the table.
A penny is taken away for  every 30 seconds that passes without cooperation. Kids hate seeing something concrete being taken away.
If your child is old enough, this is a great math opportunity. A 10 day course of antibiotics can be worth 2 dollars (adjust the reward however you choose)

Never try to sneak medicine into a larger volume of food or drink. Your kids will know it is there. If they do end up taking only part of it, you will have no real idea how much of it they got.
I have actually had some pretty young kids who hate taking liquid medicine learn to swallow capsules or pills.
I start with tic tacs or other small pieces of candy. See if they can swallow one. If they fail, Oh well. They have a piece of candy in their mouth. If they can’t swallow it with water, try putting it on a spoon tucked  into some yogurt or jelly and see if it goes down.
Remember you are doing this with your child’s involvement. No sneaking things. Don’t lose their trust over something like this. You are on the same team, trying to help them feel better.

I just discovered that the pharmacy at 450 Sutter will compound  any medication. They can turn an antibiotic into a yummy tasting gummy. What a concept. They also deliver.
Their phone number is 392-4137. If this is an option you are interested in exploring, give them a call.
This is an especially good option for the Zithromax.

Most kids do end up taking some syrupy medications at some point or another. Please make sure you brush their teeth after each dose.
If they are taking antibiotics I strongly suggest that they also take probiotics to protect the body chemistry and prevent yeast. Ideally, don’t give a probiotic at the same time as the other medications, but stagger it throughout the day if possible.

Some children take a daily medication or vitamin pill and quite like them.
Telling your child that medicine and vitamins are not candy and can only be given by the grown up is a start, but it is also essential that they are kept in a child proof area. If your child does take an overdose of any medication call the Poison Control Center to find out how concerned you need to be.
Poison Control number for California is 1-800-222-1222

If you are ever giving a medication and are not sure about proper dosing, never hesitate to call your doctor’s office/ advice nurse for clarification.

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