Feeding oral meds to children

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How do you coax children to take medicine, especially horrible-tasting antibiotics?

Do you feel it is ok to hold the child down to feed oral meds, of course, with parents' consent.

I have experience a few encounters that the child would refuse to take medicines, and we need to hold the child down to feed the medicine. Some parents have even told us to pinch the child's nose as we push the medicine in.

In a 32-bedded paediatric medical ward, we seek parent's cooperation to feed the medications, but when we do our rounds, we will find the medicine still sitting around, and it can cause medication errors.

Can you guys given me some feedback or suggestion on how we can improve our medication adiministration. Each team (of 2~3 nurses) takes care of about 9 to 12 patients.

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Specializes in NICU, PICU, PCVICU and peds oncology.

It can definitely be a challenge. I would never leave a med for a parent to give later - too much risk. When I ask parents to give the med, I stand by until it's in. Depending on how old the child is, you can offer them a choice of "taking it now, or taking it in 10 minutes" or after a story or some other bartering tool. The really little ones who still drink from a bottle might take it from a nipple, mixed with a little bit of milk. That's the easiest way to give babies oral electrolytes. You'd have to mix the med into the milk a little at a time. When I do that I draw up the med and a reasonable amount of milk/formula into syringes then bundle the baby so their hands aren't free. I remove the nipple from the package and pop it in their mouth, trickling a little milk in there when they start sucking. Then I put a little more milk with some of the med until it's all gone. It takes a bit of coordination, or a second pair of hands, but it works. If that's not an option, then insist that the parent hold the child on their lap - bundled in a blanket if necessary - and have them open the child's mouth. Never threaten a kid with a needle unless there's no alternative, and don't let parents do it either... Threats tend to backfire. If all else fails, get an order to place a feeding tube for meds.

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Specializes in Critical Care.

Tell the kid if they don't take their medicine Santa dies. Works everytime.

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Specializes in NICU, ICU, PICU, Academia.

I have found that pancake syrup masks the taste of even oral steroids- the worst bitter taste on the planet outside of quinine.

And ditto on the PP- NEVER leave a med at the bedside. The parent is not signing the legal document that is an MAR- YOU are! Really bad, terrible, awful practice.

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Tell the kid if they don't take their medicine Santa dies. Works everytime.

Lol!!

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Specializes in Acute Care Pediatrics.

I have gotten pretty good at the squirt down the throat method.

There is NOTHING worse than a screaming kid over medicine. That's a basic life skill. Irritates me to no end, especially the parents who let the kids win!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I worked with kids who were under 2 years for the most part but I'll never forget the nurse who promised to do a little silly dance for a recalcitrant 4 year old as he slurped the icky stuff out of the medicine cup. It wasn't a big production, just sort of subtle Irish Jig. :-D

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Specializes in NICU, PICU, PCVICU and peds oncology.

I've never tried maple syrup as a vehicle but found chocolate pudding to be great for steroids. Of course, we can't even get Jell-o for our patients any more so other means must be developed.

Squirting meds down a screaming kid's throat wouldn't be my first choice due to the risk for aspiration. But I could be persuaded to try the dance moves!

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Specializes in NICU, ICU, PICU, Academia.
I've never tried male syrup as a vehicle but found chocolate pudding to be great for steroids. Of course, we can't even get Jell-o for our patients any more so other means must be developed.

Squirting meds down a screaming kid's throat wouldn't be my first choice due to the risk for aspiration. But I could be persuaded to try the dance moves!

Do you want to edit this- because 'male syrup' is just....well......

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I like all the ideas, I know it is hard. Maybe this is a DUH comment, but pharmacists can add flavoring to liquid medications. Maybe involve the child in what flavor do you want the Dr. (they may understand Dr. better than pharmacist) to make your medicine?

Maybe if you're lucky it will work in 1 out of 10 situations :).

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Specializes in Complex pedi to LTC/SA & now a manager.
I like all the ideas, I know it is hard. Maybe this is a DUH comment, but pharmacists can add flavoring to liquid medications. Maybe involve the child in what flavor do you want the Dr. (they may understand Dr. better than pharmacist) to make your medicine?

Maybe if you're lucky it will work in 1 out of 10 situations :).

Outpatient pharmacies do (often for a charge) but it's almost never an option while inpatient. Hence the pudding, maple syrup, chocolate syrup etc

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Specializes in NICU, PICU, PCVICU and peds oncology.
Do you want to edit this- because 'male syrup' is just....well......
OMG, how did I miss that? :o
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