Tips for giving medicine/A useful list of considerations when giving any medication

 

Tips for giving Medication

Parents have to pick their battles. Sometimes things aren’t so important. Does your child insist on getting the favorite but dirty shirt out of the hamper and wearing it for another day? Not such a big deal. I am a big believer of the “Don’t sweat the small stuff” way of thinking. I am also a fan of discussion and compromise when appropriate.  But once in a while, you need to establish that you are the ultimate decision maker, especially when there are health and/or safety considerations. Most of the time, the ‘medication battle’ is one that you need to win. Let's assume that your child has a condition that needs to be treated. If this is the case, have a firm but loving attitude. (Think Mary Poppins and her spoonful of sugar.) Make it clear that you mean business. Your child will be getting the medicine, one way or another. This is not a choice. For young infants, take advantage of their natural sucking reflex. There are some useful products available to help administer meds: Frida Baby Dr Brown If they are resisting, use the following technique. Hold them at roughly a 45 degree angle. If they are flat they are more likely to aspirate. If they are sitting up too high they can spit. Getting the right angle makes a big difference. Wrap them in a blanket (think straight jacket!) This will keep them from being able to use their arms to knock the medicine away. A syringe is much more effective than a spoon and is better for measuring. Make sure the numbers haven’t worn away. Dr Hurd suggests asking the pharmacy or your doctor's office for a fresh one at the first sign of any wear. Squirt a small amount into the side of the cheek. Keep the chin elevated. Give a tiny bit at a time and wait for a swallow. The key to this method is not giving too much at one squirt. For a 5 ml dose of something I would break it up into 10 squirts of .5 each time. Here is a rather amusing TikToks of Dr Ted and I demonstrating the technique Accept the fact that your child may be crying and screaming throughout the process. It usually gets easier. Allow yourself ample time for this. If you are rushed, you will be more stressed and apt to get aggravated. This method can be used with any age as needed. The only kids that can beat this system 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 they can get an injection. ( As tempting as it might be, please do NOT use getting a shot as a threat) If you are trying to get in a dose of fever reducers, suppository form might be your best option. If you have an especially challenging kid on your hands, see if there is a compounding pharmacy near you. A good compounder can make medications in different flavors such as grape, strawberry, marshmallow etc. Other meds can be made as liquids, suppositories or topical gels. My compounder of choice is Eddie Lau over at Feel Good Compounders. The phone is 650-898-8221 or info@feelgoodcompounders.com Be aware that compounds need an in-state prescription even for over the counter medications. Ideally you don’t need to use force. For kids who are old enough to reason, give them some choices: What would they like to drink after the medicine?  Should we have the pharmacy add a flavor? Would they like to try holding a lollipop and taking a lick after each squirt? If they cooperate and do their best to get the medicine down, make sure to give them lots of positive feedback! Don’t wait until your child is sick to teach them about cooperation with medicine. Try doing some role playing ahead of time. I have several approaches. Make it a game with some role playing. Have one cooperative stuffed animal and one stuffed animal (or doll) who is not going to take that medicine without a fight. The cooperative doll says things like, “ I know this tastes a little yucky, but it is really important and it will help make me feel better". You then respond, "I am really proud of you for being so cooperative." For the challenging doll, wrap the arms in a blanket the way you may have to with your child. say, "I am sorry that this is so hard, but it is very important for you to take this medicine." You might also let them pretend to be a parent who has to give the medicine to the uncooperative doll. Don't make it easy. Role reversal can give both sides some insight. If you don’t have the energy to put on a show, you can simply tell a story.  “Once upon a time there was a little boy named Gus who had an ear infection. He needed to take medicine, but it tasted yucky and it made him scared to try. His mommy gave him some fizzy juice and every time he took a bit of the medicine he quickly took a sip of the juice. He was so proud when he took it all, and soon his ear started to feel all better!" Incentive or rewards You can always have a standard sticker chart. Or if you are feeling more creative, another reward method is to make it possible to earn 10 pennies per dose. This will appeal to all the future business people. Put the money on the table. It is theirs to lose. Remove a penny 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, twice daily course of antibiotics can be worth 2 dollars (adjust the reward however you choose.) Role playing, rewards and giving some choices will only go so far. When it is medicine time make it clear that any discussion will last no more than 5 minutes. Set a timer. When time is up, they can either cooperate or be wrapped up and given the medication in the method I describe above. When the kids realize you mean business they often stop the vigorous fighting after a few doses. If they think they can change your mind, they will continue to struggle. Here is an assortment of other tips, tricks and considerations. Not all medical records communicate as well as I would like. If your child is on any medications, take all of the meds with you (in the original containers) to your doctor's visits. If you can’t take the actual medication, at the very least take a photo. This is especially helpful in an urgent care situation when they don’t know your child or their medical history. Make sure you understand any medications that your child is taking: Dosage Storage Interactions with food or other medications Should it be taken on empty stomach or not Any special issues with sun exposure? Do NOT hesitate to ask your pharmacist, advice nurse or doctor if you have any areas that need clarification. If the dosage or quantity seems odd to you, ASK!!! I have seen medication errors avoided because the parents were savvy enough to express concern. Check your child’s body and skin before you give the first dose of a new medication. This way there will be a clear timeline if a rash shows up. Don’t 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.  Your kids are not necessarily putting on a show. Some medications are really bitter. The generic ones are often the biggest culprits.  Make sure to do a thorough teeth brushing after taking a liquid medication. Many of them are syrupy and full of sugar in order to increase compliance. If your kid constantly fights taking liquid medications, consider trying to teach them how to swallow pills. You would be surprised how some really young kids can have success. 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. Once they manage to get the tic tac down, ask your doctor what pill forms are available. Some children take a daily medication or vitamin pill and quite like them. Dr. Hurd cuts the gummy vitamins in quarters. Her kids have a positive association with taking something daily and there is no fussing involved. The problem can be when they like them too much! I remember a 9 year old patient who had a mysterious ongoing stomach ache. After some questioning, it turns out that he was helping himself to a handful of gummy vitamins daily. It is important to have all medication and vitamins stored safely in a childproof container. When I was a kid, my mom had our chewable vitamins tucked on a high shelf in our pantry. I have clear memories of my sister Marjie and I climbing on a stool to get them down and have “vitamin parties” . I firmly place all blame on my older sister here. She was usually the one with all the grand ideas. Fortunately we limited ourselves and didn’t have any consequences that I am aware of. Remind your children that medicine and vitamins are NOT candy and can only be given by a grownup. (I imagine that my mom did that….) Realize that that might be useless and take a moment to evaluate how ‘childproof’ your situation actually is, in case you have a little Marjie. If there is ever an overdose concern, call the Poison Control center. Poison Control number for California is 1-800-222-1222 Measurement guide Measuring Spoon Metric (1 mL = 1 cc) 1/4 teaspoon = 1.25 mL 1/2 teaspoon = 2.5 mL 3/4 teaspoon = 3.75 mL 1 teaspoon = 5 mL 1 ½ teaspoons = 7.5 mL 2 teaspoons = 10 mL 1 tablespoon = 15 mL 1 ounce = 30 mL Special shout out to Dr Sophia Hurd for doing a read through and adding some extra pearls.