Use mini M&Ms to teach kids to take pills

Cold and flu season is in full rage, and so is the battle to get kids to take medicine.

Maybe it's because they are also finicky eaters, but my kids have always hated to swallow liquid medicine, no matter the flavor. Imagine the frustration of trying to comfort a child with a raging fever who can't manage to swallow the medicine that will take the infection away or relieve the pain. Not even Mary Poppins' cheery advice would make this medicine go down. The toddler wasn't the only one in tears.

We tried mixing it with milk shakes, applesauce or yogurt but that rarely worked. Then we concentrated on getting the right medicine flavor, but even the popular bubble gum flavored antibiotic was rejected. The vanilla milky Omnicef was the only one they seemed able to choke down. Then when it came to pain reliever, only the grape-flavored Motrin would do. That was an expensive series of experiments, let me tell ya.

Too often, I resorted to some sort of bribe to get him to take it in one shot, followed by a favorite drink and then it was off to the video store to rent the bribe (usually a game, because then I could use playing time as my bribe for the next dosage). I want to add here that I got a lot further with empathy than power plays. Simply saying "I know this stinks that you hate the flavor of this medicine and it must be hard for you" made a battle a lot less likely.

So we had good motivation to get our kids to take pills instead of liquid medicine -- and so did they. At about the age of 5 we had a talk when he was healthy about how much he doesn't like to drink medicine and how life would probably be easier for all of us if he learned to take pills like Mommy and Daddy do. To practice, we used mini M&Ms and I first demonstrated by putting it far back in the tongue. For a visual tip, I explained we were sending it "down the river" in one swallow.

For both kids, it ended up being surprisingly easy to teach and they were so proud of themselves that they were doing such a grown up thing. So recently when my 6 year old had a battle with strep, I got the antibiotic in pill form. Unfortunately, they were those chalky white pills and kind of large so we had to cut them in half and he struggled sometimes to get them "down the river" in one swallow.

But every time he started to get frustrated over the bitter melting pill in his mouth, I reminded him we could just go back to the drinkable medicine. In a snap, he was back at the counter to get a refill on his drink to swallow his pill.

-- Sharon Kennedy Wynne

Comments

[amy]

First of all, the American Academy of Pediatrics says to avoid calling medicine "candy". It is reasonable to assume that the average 5 year old will soon begin to equate medicine with candy even if you say it's "pretend". Second, the research study you linked to says specifically that the children were given neutral placebos and likening taking medicine to eating candy was discouraged. Did YOU actually read the study? Frankly, I'd take the word of the AAP over some random internet doctor on babycenter who doesn't follow the AAP recommendations. In my own personal experience I found that squirting a little aerosol whipped cream or dripping a teaspoon or so of hershey syrup straight from the bottle afterwards always gets my kids to swallow their medicine. Same sweet reward but no chance of pill/candy confusion. And the kids think I'm awesome.

[SM]

I can see both sides of this debate. When our daughter was in kindergarten she came down with pneumonia. Fortunately, she was not hospitalized but we had to give her some heavy duty oral antibiotics at home. Needless to say, they tasted horrible. Absolutely horrible. No matter what flavoring we tried from the pharmacy, the bitter odor and taste was still there. It would literally take an hour to convince our child to take it. And then she would gag and spit it up and we couldn't tell how much she was actually ingesting. There were times my husband and I had to hold her down and use a syringe to let drops of medicine stream down her throat. That was awful for all of us. Nothing like having to force medicine into a very ill child to make you feel like a bully... We finally discovered that getting my husband to do really silly things (like dancing with our dog!) that would make her laugh was the key to getting her to finally unclench her jaw and swallow the dreadful liquid.

That being said, I understand why it is helpful to teach children to take pills. On the flip side, I do worry about the correlation between meds and candy. Because many parents aren't responsible enough to teach their children to take pills by using candy for practice. And something as seemingly innocuous as iboprofen (compared to oxycontin or other pills) can look like brightly colored candy to a toddler. Especially if in their minds, a linkage has been made between candy and medicine. Just one adult dosage pill of ibuprofen is a dangerous amount for a child..

So while I see Sharon's point about all of this and I think this is useful for children who are old enough to understand the difference between pills and candy, I definitely understand why Healthcare Mom is so alarmed by the content. Not all parents are smart enough or responsible enough to explain this appropriately to their children.

Our pediatrician only broached the subject of trying pills vs. a liquid rx in the last couple of months-- and our daughter is now 9. There was no mention of candy in the conversation of learning how to swallow pills. His suggestion was to use small chips of ice for practice (since they'd melt if she couldn't get them down) and wash them down with a favorite drink.

[smallbird]

no, ha ha, i didnt read it. but i admit, your response did make me curious, so i did go back and read it! boy do i look like an idiot!!! im sure it can be difficult to get kids to take medicine that they dont like, but maybe a more creative solution needs to be found. still dont like the idea of teaching young kids to equate pills with candy, no matter how strongly the parents believe they have the meds on lockdown. kids are determined, resourceful and curious...and not to be underestimated!

[Gina]

Hello? Did you read the article? If kids don't like the flavor of liquid medications, learning to swallow pills make it easier for them.

[smallbird]

while i disagree simply because i think it is irresponsible to teach kids equate pills and candy, the more fundamental question I have to ask is what is the hurry? why is it necessary to teach young kids to swallow pills? there are plenty of liquid medications available and children will learn in their own time to swallow pills. why rush that?

[SP]

In the interest of bringing this back on topic, I used soda as an incentive for the kids to learn to swallow pills (my kids get soda very rarely). Once they took their pills a few times that way, they had no problem doing with water or juice.

[HealthCareMom]

Ms. Wynn,

I am not off topic. In all my years of health care practice, health care education and parenting no physician I have ever encountered endorsed this practice.

I also believe, again, you are assuming every caregiver has your level of intelligence and/or common sense.

Since you posted this in a public forum I feel it is my obligation as a health care professional not only to educate as to the dangers of this practice but provide additional information for others.

That includes the National Poison Control Hot Line number because some poor parent is going to need it after following your advice.

[Sharon]

This is now really getting off track. Locking down medicine is a different issue. You may find a method of using candy to teach disturbing, but it is endorsed by physicians.

I am not sure what you expect parents to do. Never teach their kids ever? Do you also lock down all the candy so they cant' be confused with pills? This logic makes no sense.

ALWAYS call the poison center immediately if you think there's been a poisoning. NEVER wait to see what might happen. Keep the poison center number on or near your phone:

1-800-222-1222.

I am not saying kids can not be taught to take pills.

It's your method of using candy that is disturbing!

Looking at participating poison centres’ records over a span of 3½ years, researchers found that more than 9,000 kids ingested a prescription painkiller (mostly hydrocodone and oxycodone), and with horrible results: eight deaths (every one a child under the age of 3), 43 life-threatening or debilitating illnesses, and 214 moderate but not deadly effects. And those numbers may be only part of the story, since many poison centres weren't accounted for.

The best defence against accidental medicine poisonings is storing all medications – prescription and non-prescription – in a locked cabinet, far from children's reach. Even items that may seem harmless, like mouthwash, can be extremely dangerous if kids ingest them in large quantities.

And parents often have some common misconceptions about medications:

Just because cabinets are up high doesn't mean kids can't get their hands on what's in them. Children will use whatever they can – the toilet, countertops, stools, stacked books – to get to items in the medicine cabinet.

Simply telling kids that something is dangerous won't deter them. In fact, knowing it's a no-no may tempt young kids to try the mysterious medicines even more. And older children and teens may even be looking for potential high-inducing meds.

Child-resistant packaging does not mean "childproof". Even toddlers and small children can open child-resistant medicine bottles.

Never rely on any kind of packaging to protect kids.

Never leave vitamin bottles, aspirin bottles, or other medications on kitchen tables, countertops, bedside tables, or dresser tops. Small children may decide to try to copy adults and help themselves.

Never tell kids that medicine tastes like candy.

Talk to relatives, childcare providers, babysitters, and family friends about their medications, too, especially if your children visit or stay there frequently. Explain the importance of keeping all medicines and hazardous substances out of kids' reach and, ideally, locked away.

Make sure purses and bags – yours and guests' – that could contain poisonous items (like medications) are kept out of the reach of children at all times.

Politely ask visitors if you can put their belongings in a designated place so the kids won't get into them (say your children like to go through wallets or play with lipstick if you feel awkward about mentioning medications).

Don't keep medicines in your car, where kids may find them as they get in or ride along.

Always store pills and liquids in their original containers.

Try to keep a record of how many pills are left in a prescription container.

Avoid stockpiling medicines and throw away what you're no longer using.

http://www.virtualcancercentre.com/news.asp?artid=12479

[Sharon]

Pediatricians do this very thing. Read this:

http://www.med.umich.edu/1libr/pa/pa_pillswal_hhg.htm

and this
http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=1629

and this
http://parentcenter.babycenter.com/404_how-can-i-teach-my-child-to-swallow-a-pill_70926.pc

the last one says children as young as 3 or 4 can be taught to take pills.

Sure, some idiots out there don't lock down their medicine. That doesnt mean you can't tell responsible people how to make their life better.

[HealthCareMom]

Ms. Wynne,

You are doing a disservice! Please discuss this with your pediatrician!

You are also assuming that all parents have common sense, which we know is not the case.

Please, I urge you to research the danger of this practice.

Accidents can and do happen.

[Sharon]

That's a valid point of view but I respectfully disagree.

We are talking about a 5 yr old here, not a toddler. He most certainly can tell the difference. Do you not know any kids that age? He is not told medicine is candy. He's told the candy is practice for when he does have to take medicine.

And Grandma's pills should be locked down so that's a red herring. We talk early and often about not touching medicine bottles and they are always kept out of reach.

This reminds me of the argument that you shouldn't teach a kid to swim before age 5 because it can make the parents too lax. Teaching a kid as he grows shouldn't replace supervision. But that doesn't relieve you of the duty to teach. And in this case, it makes the child healthier because he can take his medicine and feel better.

[Sharon]

That's a valid point of view, but I would respectfully disagree. We are talking about a 5 yr old, not a toddler and he wasn't told medication is candy, he was told we were using it as practice for the time we really do need to take medication. A kid that age most certainly can tell the difference. Do you not know any?

And grandma's pills should be locked down and out of reach, so I think that's a red herring. Medicine is always kept out of reach but we also talk early and often about never taking it without an adult.

This reminds me of the argument that you shouldn't teach a kid to swim before the age of 5 because it might make the parents lax. Teaching a child as he grows should never replace supervision. But that shouldn't be an excuse to never teach.

[HealthCareMom]

NO, NO, NO!! This is the worst idea I have ever heard!!!

Any health care professional will tell you NOT to teach kids that medication is candy!!

NO, NO, NO!

Kids can't tell the difference. To them it all looks the same. And when they take grandma's entire bottle of brightly colored heart medicine and OD's, parents will have a tremendous heart ache with a dead kid!

[Tina]

Great idea! I also find the dissolving strips work well. I am going to try the M&M trick, though. Thanks!