This post is also available in: Svenska

Giving children medicine is one of the difficult parts of parenting. Children are often given liquid medicine, but it’s common for them refuse to take it. Or you give the medicine to the child, but the child vomits soon afterwards. It is especially common with Penicillin VK (phenoxymethylpenicillin), which is a commonly prescribed penicillin that tastes very bad. How do you give young children penicillin?

How important is it to give the medication to the baby?

It depends on what the medication is. It depends on the reason you’re giving the baby the medication. And it depends on what can happen if you don’t give the medication. When it comes to painkillers and anti-pyretics (or fever-reducing medicines), you can and should make these decisions yourself. If you’re in doubt, make the decision with the other parent, if there is one. Say, a child is not sleeping through the night because of the pain, then it is considered important to give the child the painkillers. If the child is hanging out on the couch and eating ice cream while watching TV with a fever, then it is not nearly as critical to give the child the anti-pyretic medication. However if the child becomes dull or slow from the fever that they cannot be bothered getting something to drink, then it is important to give the child anti-pyretic medication.

Ask your doctor for help

When your child receives a prescription from a doctor, the doctor has the responsibility to provide you with all the information. Make sure you get the answers to the following questions: what is the medicine prescribed for? And what are the risks of not giving the medicine? Then it is you as a parent who has to decide whether the child should receive the medication or not. As a parent, you have the right, if necessary, to force children to take important medication. However, the coercion must be as short-lived and as mild as possible.

Thus it is really important to get this information from the doctor! Many chronically ill children are on medications that protect them from severe complications of diseases where the results are not seen until several years later. And even though there is no difference in how they feel today, this week or next, whether they take the drug or not; then it is still your responsibility as a parent to ensure that the child receives the medication every day at the dose that is prescribed. And in order to take that responsibility, you need to know how important this medication is and why.

Some medications are put to the test, “if it helps, it’s good and if it doesn’t help, it’s still not a dangerous disease”. This is also really important to know as a parent. I wouldn’t need to force that kind of medication onto my children.

Forms of medication – tablets, liquid or suppositories?

Tablets

These can be easier to give to children than liquid medicine. My experience is that even children as young as 1-2 year olds can take tablets in some cases. If you want to try, please do as follows:

Stretch your tongue out at the baby, like a prank.
The child will likely imitate you. When they do, you can then put the small tablet on the child’s tongue.
Quickly show a glass of juice or anything else the child recognises as delicious.
If you are lucky, the child drinks the juice and the tablet is swallowed.

So try giving tablets first if that is possible and ensure the tablets are small. As for Penicillin VK (phenoxymethylpenicillin), the most common ill-tasting liquid medication, there are low-strength tablets suitable for young children available.

Many tablets can be crushed and mixed in, for example, a small amount of jam (ask your pharmacist or doctor if this is possible for the medication you are giving your child). The problem with this is that any disgusting taste is released when the tablet is crushed. And sometimes children will not want to taste that ‘jam’ anymore, because they associate the taste to the disgusting tablet. However, many parents still find tablets easier to give than liquid medicine.

Penicillin tablets in children can be really small and easy to swallow.

Liquid penicillin

Liquid medications are usually sweetened and flavored with the same type of flavors as “fruit” candy. As long as the drug itself does not have a strong taste, liquid medicine tastes more or less sweet. Examples are liquid Children’s Tylenol and Advil, which are often easier to give to children if it tastes good.

Some medications have a strong, penetrating, bitter taste which is not significantly improved by adding artificial fruit flavors. The penicillin Penicillin VK (phenoxymethylpenicillin) and Floxapen (flucloxacillin) are the most common. My friend’s children described the taste of the Penicillin VK as: “Mom, the medicine is gross! The cat must have farted in the medicine bottle!” My first tip here is to try giving the medicine in tablet form.

If you need to give liquid phenoxymethylpenicillin, it is good to know that it is available in three concentrations in Sweden: Kåvepenin fruit 50 mg/ml, Kåvepenin 100 mg/ml and Kåvepenin oral drops 250 mg/ml. There is a big difference between how much you give your child depending on which concentration the doctor chooses to prescribe. For a 10 kg child (one-year-old) with otitis or ear inflammation, the standard dose is 250 mg. That is 5 ml of Kåvepenin fruit 50 mg/ml or 2.5 ml of Kåvepenin 100 mg/ml or 1 ml Of Kåvepenin oral drops 250 mg/ml.

The more concentrated the medication, the more disgusting it’s meant to taste. Having said that, I haven’t met anyone who has tasted the less concentrated version (Kåvepenin fruit 50mg/ml) and said it tasted more fruity. Most parents I meet prefer to give a small amount of concentrated Kåvepenin over giving a larger amount of the less concentrated version. But it’s different. See what has worked well for your child and if it’s the first time then see what you think will be easiest.

I think it is easiest to give liquid medicine through a syringe. You can obtain this for free at the pharmacy checkout in Sweden.

Suppositories

Suppositories are medication preparation inserted into the rectum or bum. These work well with diaper wearing babies. But is often intrusive for children from 3-4 years. At that age, I prefer giving tablets. And if it is not possible, then give liquid medicine. Penicillin VK and other antibiotics are not available as suppositories.

Forcing children

If the child refuses to take a liquid medicine that you as a parent, with or without contact with a doctor, deems important, I do not think that you should try to persist, badger and nag. And by all means, do not threaten the child! Don’t say mean things to the child, such as “every other child knows this,” “your big sister can” or “get it together”.

Instead, make the suffering quick. Make up your mind and say, “This is an important medication. You have to take it. If you don’t take this medication before I count to three, I’m going to hold you down and squirt it into your mouth.” Then count to three. If the child has not taken the medication, put them on your lap. Hold the child’s arms with your one arm. If the child screams, insert the syringe into the mouth at lightning speed and spray the contents far back into the throat. If the child clenches their mouth shut, you can insert the syringe through the lips, on the outside of the teeth and spray far back so it flows down. Or if there’s two of you. Hold the child’s nose so they open their mouth.

Sometimes you have to hold onto children and force medicine into them.

As soon as the child gets the medication, let go and let the child run away if they want to. Or allow them to hug you and cry. Now that it’s done we move on to… Comfort! Ensure that for the next 15 minutes you can devote yourself entirely to your child’s needs. Use your smoothest voice and assure them that it’s over for now and won’t happen again until it’s time to take the medication again (and tell them when that will be). Now you can play or read a book or hug, or make mischief, or jump in bed or whatever the child wants. Give a small reward like candy or whatever else the child likes.

If the child vomits after each dose

Some children vomit 0-30 minutes after each dose of antibiotics. If this happens to your child, call the clinic that has prescribed the medication. Often it helps to change the type of antibiotics and you can do this by phone.

Good luck! And remember, when it comes to young children, it is you as a parent who decides whether the child should take the medication. Not the baby. Not the doctor.

Penicillin or antibiotics in children, Penicillin VK, Floxapen or Amoxil?

Children’s Tylenol and Advil in children – dosage for pain and fever

Fever in babies and children – what to do and when is the fever too high?

Ear inflammation (otitis) or ear pain in children – symptoms and treatment

Impetigo in children – infection and treatment

Streptococcus in children – tonsillitis, perianal strep and scarlet fever

Toddlar tantrums – how to deal with three-year defiance in children

When you can’t cope with your kids – bad mom or just tired?

All posts about childhood diseases can be found here