Resources and information for parents of children with cancer . . . by parents of children with cancer.

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How to get kids to take . . . Pills!

The topic of kids and pills comes up frequently in the online discussion groups. There seem to be as many ways to get kids to take pills as there are kids! Here are a few suggestions from seasoned parents, parents of kids with cancer. These parents are the authors of this page, and they deserve a large round of applause. Feel free to email the editor with your own suggestions! Also see (off-site links):

Note: This web site, ped-onc.org, does not host advertising, nor does it receive funding of any type from the display of commercial content or advertising. A couple of the links on this page could be construed as advertising. My intent is not to benefit these companies, instead, my intent is to let parents know how to find sometimes unusual items that can help their children. This is a page of parent suggestions!

Crush and Mix

There are many variations on this theme. Many of the references below are how to overcome prednisone aversions, as it seems to taste the worst of all the chemotherapy oral medications. Note, sometimes "prednisolone" can be substituted by the doctors, as it seems to work as well as prednisone but tastes better.

The basic strategy is to get the tablets, crush them, and place them in a small amount of food that your child likes (applesauce, juice, etc). Try not to choose a food that has a local significance to your area, like BBQ in the South, maple syrup in the Northeast and Canada, orange juice in Florida, because they can easily grow to hate this food in the future, and you don't want to make them a social outcast. Make sure that your child eats or drinks every bit of the food with which the medicine is mixed. Be prepared to try a different mixture if suddenly your child refuses to eat the latest successful concoction.

Note: Just a reminder . . . check with your pharmacist or doctor about crushing pills. Not all of them can be crushed.

One parent purchased a pill crusher from a company called "Health Care Logistics" and found it worked a lot better than the plastic one they were given by the hospital. This is not a commercial recommendation for this company, but the web site is www.healthcarelogistics.com.

Ice Cream and Chocolate

Candy and Sugar

Fruits and Juices

Flavor-X

SwallowAid

Use a Syringe to Deliver Oral Meds

This is a variation on mixing with food and getting your child to eat or drink the pills. The pills are crushed and mixed with liquids, then placed in a syringe, a syringe without a needle on it. Then, you can quickly squirt the mixture into your child's mouth. A syringe is likely to be used with the younger kids.

Place in Gel Caps

Some of the oral meds have an awful taste, even if they are swallowed quickly. Many of us have found that they go down a lot easier if they are crushed and then put in gelatin capsules. These capsules are available at pharmacies for a nominal fee and come in several sizes, with the smaller numbers designating larger sizes. But to take even these, they still have to swallow them, which brings us to . . .

How to Teach Your Kid to Swallow Pills

This subject brings a little levity into the cancer parents' lives. At least it does when it's not your kid you are trying to teach. I'll start off with a couple long stories:



Anecdotes

So, you think you have it bad??

I wanted to weigh in on the pills topic, as we also have experienced difficulty with prednisone. [My son] is now just 2 years old, and when he was first prescribed prednisone would vomit upon swallowing. Of course, this didn't stop the doctors/ nurses trying to give it to him - but after 5 doses in one try, they switched us to prednisolone. Well, that lasted until he got onto maintenance, and then our staff doctor wanted him switched back to prednisone. When my wife (who does all the hospital stuff as I'm at work) pointed out he was either going to a) vomit, or b) spit it out, our doctor demonstrated the famous "give a cat a pill" technique - pinion him, plug his nose and jam the stuff down his throat, hold his nose until he swallows. Fair enough - it worked.

So then we started into the 5 days per month regime - dreading the whole thing. (I've noticed in several of the e-mails I have already received mention of how prednisone affects the personality of the patient - I don't know about how my son feels - he is just starting to talk - but we sure notice the change!) Any rate - my wife would give his dose 3 times a day -- wrestle him down, plug his nose and feed it to him. I should mention that we always mixed the prednisone with maple syrup.

One night, I was home, giving Deb the night off, and had to give him his dose. So I prepped the pill - ground it up, mixed it with syrup, sucked it up into a syringe (no needle, of course) and then found my son.

He knew what was coming, started to cry; I grabbed him, pinioned his legs between mine, held down his hands with one hand, and got the syringe to give him his steroid. And looked at him. It was funny. I could see in his eyes he was ready to talk about this. So I let him go, stood him up and said, "Buddy, it's yucky medicine time. I know how awful it tastes but you have to take it. Tell you what I'll do - you take the medicine, don't spit it out, and I won't hold you down." And then I had a brain wave - I went to the kitchen and got some chocolate chips. I looked at him and said, "Look, I'm going to give you a chocolate chip now, it'll make your mouth taste all good." He ate the chip. The I said, "OK, here comes the yucky medicine, swallow it fast, and you can have some more chips." my son took the prednisone, whole syringe, swallowed it, no spitting it out, no fuss, and filled his mouth with chocolate chips."

Since then, all we do is tell him "yucky medicine", he looks for chocolate chips, takes about 3 in his mouth, takes his prednisone, more chips, end of story.


If it makes you feel any better, my daughter never accomplished swallowing pills. She was 7 1/2 at dx, finished at 10 and 2 1/2 months, will be 11 in a couple of weeks and still CANNOT swallow a pill to save her life!! Believe it or not, she chewed her pills up. This terrified her drs- What will happen to her teeth? Well, she still has no cavities, no plaque problems. The only problem she has is receding gum lines and horrible tooth alignment- neither of which could be from chewing pills.


Once we switched to Bactrim pills, my daughter decided she didn't want those either. So we threatened to call the hospital to prepare a "pokey". When she called our bluff on that one, I called my fax machine number and "talked" to the fax about preparing the "pokey". That worked for a while until she figured out that Beaumont was a zone call (needed the area code prior to the number) and my fax number wasn't. After that every with every pill I would call my mother in Kentucky and pretend she was Beaumont. My mother was very confused at first but hers was the only long distance number I had memorized (other than Beaumont's).


At one stage we had to take him to hospital every night for his orals, we could not get it down at home anymore, he vomited it straight out every night. We spoke to his doc who suggested we give his orals at hospital until he gets used to taking them, as he can probably feel our tension and takes advantage of the situation. He still vomited quite often at hospital too though, but at least they were the "bad guys" (and cleaners) and not us! When we got tired of driving to hospital every night, they threatened him with a gastric nasal tube, and that's when he decided to have his pills at home. It still takes a long time every night, but with lots of fizzy drinks in between he gets it down.

General Disclaimer

These pages are intended for informational purposes only and are not intended to render medical advice. The information provided on Ped Onc Resource Center should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you suspect your child has a health problem, you should consult your health care provider.

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