Correct dose
* Read the pharmacy label carefully and double check the directions.
* 1 teaspoon equals 5 milliliters (mL).
* 1 tablespoon equals 15 milliliters (mL).
* Some medicine syringes may be marked in “cc” (1 cc equals 1 mL).
* It is best to use a device marked in mL to measure the correct amount of medicine.
* Hollow-handled medicine spoons work well,
* Plastic medicine syringes (or droppers) allow gentle, accurate placement of medicine in the mouth.
* Be sure to get an accurate, easy to use measuring device from the pharmacist when you get your child’s prescription.
Visit our Medication dosing guide for guidance on correct dosing.
Giving medicine
- Use a matter-of-fact, positive approach (expect that your child WILL take the medicine)
- Be enthusiastic (“this will help you get well!”)
- Always have child sitting up (to avoid choking)
- Pour or drip medicine slowly onto the back of the tongue (toddlers).
- 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 to prevent leaks, and give them the nipple to suck. This works well when they’re asleep, too. You can buy fancier syringe versions of this, too, but why bother?
Medicine that tastes bad
- Giving medication cold may reduce the unpleasant taste.
- Mix with something else to disguise the flavor. Some ideas: chocolate pudding, flavored syrups, Kool-Aid powder, chocolate syrup, jelly, ice cream, honey (for children older than one year only)
- Can allow child to choose flavor to mix in.
- If crushing a pill, try the above tips, or even better: scoop out the center of an Oreo’s filling, and replace with crushed pill.
- Follow medicine with child’s favorite drink
- Hug, and praise your child afterwards
Learning to swallow 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.
- Pills may go down easier in milk or yogurt, since they are more siippery.
More and more pharmacies are able to add flavors to medications. Call around and ask next time you get a prescription for your child.
How to handle medicine refusal
Some toddlers steadfastly refuse; even with above steps. The first step is to determine if medication is essential for recovery. Most symptommatic treatments and OTC medications are not essential while most prescription medications including antibiotics often are.
Always be sympathetic (“yes, it tastes bad, you can choose what to mix it with”). Be kind, firm, and matter of fact (“you can choose to take it now or in 5 minutes, but you must take it to help you get well”). Give a 5 minute time out; if child is not ready by then, CALMLY take action if refusal continues and medication is essential:
- GENTLY immobilize child
- Have helper hold child on lap; holding child’s arms with one hand and head with the other
- Be sure child is sitting up
- Open child’s mouth (push down on chin; or run your finger inside cheek, then push down on lower jaw)
- Insert syringe, SLOWLY drip medicine onto the back of the tongue
- Keep mouth closed until child swallows (keep child sitting up, with head upright)
Sympathize (“I’m sure that was not fun, next time we won’t need to do that if you choose to take the medicine”). If child spits/vomits medicine, estimate the amount and repeat that amount if occurs very soon after swallowing medication. Follow with a warm hug (AVOID: scolding, yelling, or spanking).
When to call
- Child vomits medicine more than once (generally if child vomits medication within 20 minutes of taking it is okay to repeat the dose once). If you are unsure call the office.
- You cannot get your child to take an essential medicine
Cough and cold medications
Over the counter (OTC) medications are generally used to reduce symptoms. They do not change the course of the illness. The times when symptomatic medications are most useful are for more restful sleep or to allow a child to return to school. Use medications when symptoms are caused significant discomfort. All medications have possible side effects so observe your child carefully and only continue to use the medication if it makes a noticeable improvement for your child. For young children (<2 year old) avoid OTC medications (except for Tylenol© and ibuprofen) unless directed by health care provider.
Be sure to check out related page on pain medications (Tylenol and ibuprofen) if you have questions regarding dosing and use of OTC analgesics.
Combination products are common which can include anywhere from two ingredients to some more than four. We recommend using single ingredient products which give the parent the most control in dosing accurately and not causing you to give a medication that may not be needed at that time.
There are many “home remedies” that do not contain medications. They often work as well or better than OTC medications and have much fewer side effects. These include:
* Plain tap water can be used or saline mixed from ½ to 1 tsp of salt in one cup of water. This can be used as often as needed for thick nasal congestion that is interfering with sleep or feeding.
* Corn syrup 1/2 to 1 tsp as needed for cough. It soothes the throat and works equally well as dextromethorphan containing cough medications (i.e. Robitussin©)
* Warm liquids can be used to break up coughing spasms, croup, nasal congestion, and sore throats. Increasing fluid intake in any child ill with fever is very helpful.
Benadryl© (diphenhydramine)
Benadryl© is an antihistamine that is primarily used for allergic disorders. This include allergic skin rashes like hives and poison oak. It is also helpful for seasonal allergies. In older children it can be used as an occasional sedative (like for that long plane ride). In general it should not be used for common cold symptoms at is not helpful and may increase chance for ear infection. It ts to be given no more often than every six hours. Not routinely recommend for children under one year of age unless advised by your healthcare provider.
Cough suppressant (dextromethorphan)Cough suppressants are often found in single ingredient products like Robitussin© or in combinations with other products. There is only one cough suppressant ingredient on the market currently which is dextromethorphan. Expectorants have not been shown to have any benefit. Cough and cold symptoms are generally not recommend for children under age one since infant’s symptoms rarely improve with these medications and side effects are common. Brand names are listed below for example only, not to imply any particular endorsement. Always read labels to know what strength you have.
Decongestant (Sudafed©)
Decongestants go by the generic name of pseudoephedrine. They work by decreasing mucous production (“drying up”) in the nasal passages. Currently most decongestants contain pseudoephedrine which can be easily made into methamphetamine. We do not recommend decongestant products due to this problem and they are generally not effective for young children. There are new reforumulated products coming to market which will hopefully replace pseudoephedrine containing medications. At this time labeling for these newer products are for children over age 12. We will be monitoring this closely.
