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Expert Q&A

 

By David L. Fay, M.D.
Family Physician
Associate Director, Waukesha Family Practice Residency Program

My 2 1/2-year-old son has a cough and cold. I have tried everything to get him to take the medication: mixing it with juice, talking to him and now I am currently using a dropper to "force" him to take the medicine. It isn't easy to hold him down and he ends up spitting out what I put in his mouth out or throwing it back up. Is there an easier way or is there anything else I can try?

This is a control issue. At this age, children begin to assert their independence, and it begins with their bodies. The first question to be asked is: Is this important enough to force the issue? In many cases (such as colds), medication is not necessary for the child to get well again. In these instances, forcing medication will only create problems, both now and in the future.

In those instances when medication is necessary for resolution of acute problems or for treatment of chronic problems, creativity is the key.

First, remember what this is: a control issue. If you can find a way to give your child control while also getting him to take his medication, you've found the answer. Offering rewards is one way to accomplish this, but remember that the reward must be worth it. If a medication tastes really vile, there may be no reward good enough. (Try tasting the child's medicine; if it tastes awful, consider asking your physician for another with better taste.). Remember also that at this age, rewards must be immediate. It won't work to offer a trip to the zoo three days hence. You must be able to supply the reward as soon as the miserable task is completed.

Reason won't work at this age. Simply telling him the medication is necessary for his recovery is a waste of time.

Another way is to try dry medication (capsules or pulverized tablets) and masking it in a large quantity of palatable food. Keep in mind that all the food must be consumed for the child to get all the medication.

Finally, if the medication is really necessary and he just won't take it orally, injections should be considered. This should be a last resort.

The ultimate goal is to get the child to take the medication voluntarily; be creative, be patient, and let him decide what goes into his body as much as possible.

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