Taking Your Medicine

Tips for taking your medicine. For not-so-nasty liquid meds, like tylenol:

• For infants, syringe the dose in their back cheek pocket, and blow a quick puff of air in their face
• Try putting the medicine in a nipple pulled from an infant bottle, keep your finger over the underside, and give them the nipple. Works well when they're asleep, too. You can buy fancier syringey versions of this, too, but why bother?

These are for dag-nasty medication suspensions, like tinidazole or clindamycin:

• Try mixing with the flavored espresso stand syrup of your child's liking
• Try mixing with single-serve Koolaid powder. In fact, one clever family gave a syringe of koolaid slurry without medicine to an older sibling, who ate it with visible relish. Then they handed the med plus Koolaid syringe to the patient, who slurped it down before realizing that we had given him modern medicine's bitterest, chalkiest, most foulest concoction.
• If crushing a pill (like isoniazid, since the liquid form often causes diarrhea), try the above tips, or even better: scoop out the center of an Oreo's filling, and replace with crushed isoniazid. Yummers.

It's so nice when your child can get off of those nasty suspensions. Some meds (stimulants, for example) aren't even available as liquids or chewables, and the pill size can get pretty large. There are 4-5yo kids in our practice that have learned to swallow pills, and it does make life easier. No need to refrigerate, travels well, etc ...

Here are some tips for swallowing pills:

• Practice with balled up pieces of white bread, from tiny to large, and have your child work their way up.
• Have them place the bread, a tic-tac, a mini M&M, or the pill itself at the back or side of their tongue, then drink from a straw. The straw helps it go down without stressing as much.
• Most capsules float, so lean forward when swallowing. Pills sink, so leaning back can help.

Learning to Use Spacers and Inhalers

Inhalers for asthma, when used with a mask/spacer device, work just as well as nebulizer machines, with much less time and fuss. Here are some tips:

• For younger children show them on yourself, then have them "teach" a stuffed animal, and practice on you.
• Let them play with a new mask and spacer for a while before using it for meds
• If they don't like the mouth taste of the medication, let them have a potato- or tortilla-chip before-hand, to coat their tongue, and then give them a sweet treat, fruit, or sugar-free gum afterwards to wash out the taste (from Contemporary Pediatrics)
  
• For inhaled steroids (Flovent, etc), wipe around their mouth afterwards, and give them something to drink to wask out the medicine.
  

Blood Testing for Aliens

I can't wait to try this ...

Artfully Dodging Blood-Test Fears (Contemporary Pediatrics)

Between 5 and 12 years of age, children often ask, at the beginning of their annual physical exam, whether they need a blood test. I've learned to dodge this question because, if you tell a child that a blood count is in her immediate future, she asks over and over when it's going to happen and whether it will hurt. My dodge is simply to tell the child that I won't know if she needs a blood test until the end of the visit.

Once the moment of truth arrives, I use a simple technique to distract the child. After I tell her that she will need a finger poke, I quickly add that the reason for the test is to find out if she is an alien. I then take out a test tube filled with green or purple "blood" and mention that someone from outer space came in for a physical the previous week. This usually gets the child's mind off the poke and onto whether I'm making up the alien thing and what's really in the test tube (food coloring and water—an off-label use). The technique doesn't always work, but we have a lot of fun when it does.