Things to Remember
There are some important things to remember about giving medicines to your child:
- Give only the medicines that the doctor says are O.K. Check with the doctor or nurse before giving medicines that you can buy without a prescription (called over the counter or OTC). More than one medicine at a time can cause the different medicines to work more or less or differently, so it is very important for the doctor to know about all the medicines you give your child. Keep a list with you of all your child's medicines. It is a good idea to bring this list with you when you take your child to the doctor.
- Know what the names of your child's medicines are and what they are supposed to do for him or her. (Example: make the fever go down, cure the infection, prevent an infection.)
- Know the possible side effects of the medicines. You can ask your doctor, nurse or pharmacist. Report side effects to your doctor right away (example: rash, vomiting, diarrhea). If your child has a problem with a medicine be sure it is put in your child's record and always tell any new doctors that see your child.
- You must be very sure about how much of each medicine to give. Check with your nurse or pharmacist about the exact amount and how to measure it. Even a small mistake could be dangerous in a small child.
- Be sure you know how often to give the medicine and for how long. If your child takes more than one or two medicines, ask your nurse or doctor to help you figure out a schedule. Some medicines must be taken exactly the same number of hours about around the clock to keep the amount of medicine in the blood exactly right. Others only have to be taken during the time your child is awake. Some are better if given before or after meals. Sometimes your child will need to keep taking a medicine for a time after he or she is better in order to be completely better. Some medicines cannot be stopped suddenly. Always finish the medicine as you are taught by your nurse or doctor.
- Liquid medicines are measured by:
- Teaspoons (tsp)
- Tablespoons (tbsp)
- Cubic centimeters (cc's) or milliliters (ml's)
- Always use a measuring spoon like the ones used for cooking. The spoons we use to eat with are not the same and are not as accurate.
- If you do not have a measuring spoon ask your doctor, nurse or pharmacist to give you something to measure with like a medicine cup or syringe.
Syringes or Measuring Cups
- Syringes are usually measured in cc's or ml's. They come in different sizes -- 1 cc, 3 cc, 5 cc, 10 cc, 20 cc, 30 cc and 60 cc. There are special syringes that are used to give medicines by mouth. These syringes cannot be used with needles.
- The smaller syringes (1 cc, 3 cc, 5 cc) can be used to measure small amounts, even less than 1 cc. To be safe, have your nurse, doctor or pharmacist show you exactly how to measure with a syringe.
- Medicine cups often have both teaspoons/tablespoons on one side and cc's/ml's on the other side. Always hold the cup on a flat surface and have your eye level with the cup to be sure you are giving the right amount.
- Some medicines come with their own dropper. To use it, squeeze the top, put the dropper in the medicine and stop squeezing. The medicine will come up in the dropper. Hold it at eye level to be sure the medicine is at the right line. Do not switch droppers from one medicine to the other because often the measurements are only for that medicine.
Capsules and Tablets
Some medicines only come in capsules or tablets. If a child is able to swallow one, there is no problem. If your child cannot do this then the medicine must be given another way.
- Breaking tablets
If your child has to take 1/2 of a tablet it might be possible to break it if it has a line on it. Tablets with lines are called scored tablets. The line is actually like a dent. If you place a knife blade (carefully please) flat into the line and press down carefully, the tablet will break into 2 pieces. Tablets that are not scored are harder to break evenly. You may then have to have the pharmacist prepare it for you. Some coated tablets should not be broken. Check with your pharmacist.
- Crushing tablets
Many children can take tablets if they are crushed into powder. Check to make sure it is O.K. to crush it. One way to do this is to take a spoon, place the tablet in it, place another spoon (down side down) onto it and squeeze or push the spoons together. Be sure to get all the powder off the spoon. The powder can be mixed with something your child likes.
Capsules can usually be opened and the powder or beads (which is really the medicine) put into something you child will take. Be sure to check with the pharmacist that it is O.K. to open the capsule.
How to Mix Medicines with Food or Drink
Both liquid medicine and powders can be mixed with drinks or food. Remember not to put the medicine into a large amount of liquid or food because if your child doesn't drink or eat the whole amount then he or she will not get all the medicine (Example: Don't add medicine to a whole bottle or a bowl or cereal or fruit). Use a smaller amount (1 or 2 oz of juice, 1 or 2 tablespoons of food). Mix with food that is not essential to your child (i.e. formula). Good things to mix with are juice, jelly, ice cream, apple sauce, chocolate syrup or other flavorful foods.
The taste of some medicines is very hard to cover up. If your child really hates the taste and won't take it when mixed, you can call your nurse or doctor. Maybe it can be switched to something else.
Giving Medicines to Babies and Toddlers
- Prepare and measure the medicine. Use a syringe or soft plastic dropper, or a spoon for medicine mixed in food.
- With the medicine within reach, sit in a firm, comfortable chair.
- Have a bib or towel on the baby. Take the baby in your lap.
- If you are right-handed, hold the baby in your left arm.
- Hold the baby's left arm with your left hand. Put the baby's right arm under your left arm around your back.
- Brace the baby's head and right shoulder between your left arm and chest so the head stays still. Tilt the head back a little.
- Put the medicine into the corner of the baby's mouth toward the back, along the side of the tongue. This makes it harder for the baby to spit. Give a little at a time to prevent choking and spitting.
- Gently keep the baby's mouth closed until he or she swallows.
- Never yell or show anger. Speak softly and say kind things.
- When all the medicine is finished, hold your baby sitting up for a few minutes and cuddle and comfort the baby. Offer the baby water or juice.
Giving Medicines to Older Children
Older children want to please their parents but they need encouragement and little tricks to help them.
- Keep trying different foods to cover the taste until you find one that works.
- Offer your child a choice about what he or she wants it mixed with (or maybe he or she wants it straight), what kind of spoon or cup or juice he or she wants.
- Some children do best when encouraged to take a deep breath and drink fast. Other take it a step at a time with a drink in between. Sometimes it helps to count for your child while he or she takes it.
- Offer a reward such as a sticker or star or maybe even something good to eat afterward. The bad taste of some medicine can be cut by eating plain crackers afterward.
- Never ask your child whether he or she wants or will take the medicine. Instead be firm and state that he or she must take it but offer as many choices as possible.
- Keep your explanations about why the medicine is needed as simple as possible. Connect taking the medicine not only to feeling better or having the body work better, but also to a desired activity or outcome. (Example: being able to run races again or play a sport or being able to look better or wear certain kinds of clothes).
- Get other people who the child cares about to help or encourage or reward your child.
Be matter-of-fact about it but also let your child know that you understand what a drag it is to have to take medicine. Some children will always resist taking medicine. Do not threaten, punish, hit or yell at your child if he/she has a hard time taking medicine. This will only make the situation worse and could make your child feel bad about himself. Talk the problem over with your nurse, doctor or social worker. Working as partners with you and your child, the problem can be overcome. Be patient!
Possible Problems with Giving Medicines
- Vomiting the medicine: If your child vomits within 1/2 hour, you can repeat the medicine. If this continues, call your doctor or nurse right away.
- Missing a dose: If your child misses a dose, give it as soon as you remember and then continue the regular schedule. DO NOT GIVE 2 DOSES AT THE SAME TIME.
- Refusing medicine: Use the ideas already talked about on pages 46-48. If these do not help, call your healthcare team about it right away.
- Taking medicine at school: Some schools allow children to take medicine at school. You will need to get your pharmacy to give you an extra bottle for the medicine at school. The school nurse will have you sign a consent form for the medicine to be given.
- Running out of medicine: Notify your healthcare team when you are running out of medicine so that you do not miss doses.
A Word About Pharmacies and Drug Stores
Try to find a pharmacy where the pharmacist is friendly and helpful. Introduce yourself and your child to your pharmacist and explain about having a chronically ill child. Find out whether the pharmacy is open on weekends or at night or if he will open for you in an emergency. Find our whether the pharmacist accepts Medicaid or insurance. Be friendly. Give your pharmacist some warning if you are low on a medicine that needs to be specially prepared. Remember, Medicaid pays the pharmacist very little for the medicines he makes for you. Try to always pick-up the medicines you have ordered. The better you and your pharmacist know one another, the easier it will be for you. Ask your nurse or doctor for the names of pharmacies that they have found to be helpful and friendly.