Giving medicines to children: Tips, techniques and precautions to know

Giving meds, especially the bitter ones, to children can be a management disaster; but one can’t really complain. After all, with TWICE the number of taste buds on their tongues than adults, children are bound to have a high taste specificity and … intolerance! (Yes, that’s a scientific fact! Now you know atleast one reason why being a grown-up can be nice too!).

So today we see some simple tips and tricks to know while giving medications, modern or herbal, to children of all age groups:

1. Keep it liquid.
Due to the small size and sensitivity of their throat, children find it difficult to swallow hard tablets and capsules. So the best bet is liquids, which are also better for giving accurate measured doses. Another useful form is dispersible tablets, which can be dissolved in water to make a quick liquid med. Most modern meds for children are nowadays available in dispersible tablet form, generally denoted by a ‘-DT’ suffix in the brand name.

2. Make it sweet, use carriers
Sweet is the only taste kids never deny. So, as a rule of thumb, kids’ medication should always be sweet, or made sweet using a suitable additive/carrier. Nowadays, most modern meds are manufactured with added sweeteners to make ‘Kids variants’. The trouble is only with herbal meds. This is where carriers (called ‘Anupaans‘ in Ayurveda) come in the picture. They improve not only the palatability, but also the absorption of the medicine. Milk is the natural choice. Another kids’ favorite is Honey. It is chemically neutral towards most bioactive compounds. Ghee is the next favorite carrier for Ayurveda meds, specially in Pitta caused illnesses. It, however, shouldn’t be used with meds containing iron or metallic compounds unless specifically indicated, as it impairs their absorption into the body.

Kids’ dosages are decided based on a number of factors, most importantly their weight and age. However, exceptions do exist. So always double-check with your doctor, and tally the dose written on the prescription with that on the packing dispensed by the pharmacist.
Herbal meds generally have a better safety tolerance profile for dosages, but they generally have discrete or no authentic literature on dosages, too. Below are some generalized scientific formulae for calculating kids’ doses from adult doses.

(i) Young’s formula – is based on age of the child,

Child’s dose = [Child’s age in years÷(Child’s age in years+12)] × Adult dose

For example, for a 4 years old kid, where adult dose is 1000 mg/day,

Pediatric dose = [4÷(4+12)] × 1000 = 250 mg/day

Now divide this by the number doses per day to get the actual single dosage.

(ii) Clark’s formula – is based on the child’s weight –
For this we need a child’s weight in pounds, which is obtained by multiplying the weight in kg by 2.2; so if a child weighs 10 kg, it is equal to 10 kg × 2.2 = 22 lbs (pounds).

So Child’s dose = Child’s weight in pounds ÷ 150 × Adult dose

There exist several other formulae such as the Dillings formula and Fredd’s formula, but the above described two are the most recognized and simplest ones.

4. For infants,

(i) To open their mouth, just purse the lips by pressing the cheeks gently with the thumb and index finger, and feed the medicine using a dropper, NOT a spoon. Ensure that they have swallowed the medicine before you turn your back.

(ii) Infant dosages can sometimes not be calculated using the usual pediatric formulae like the ones mentioned above. So NEVER give any medications to infants without consulting a qualified doctor first. 

(iii) Giving herbal meds: Digestive systems of newborns are not tuned for tolerating anything but mother’s milk, upto even 6 months sometimes. So, for giving herbal meds to them, a better option is to put a layer of topically absorbable herbal pastes on the mother’s breast for a few hours, then wash it off with clean water and breastfeed the baby immediately. They can also be given a special type of medicinal colon wash (see here to know more how colon washes works), but that is strictly a job for a qualified Ayurvedic doctor.

5. Remember: Baits work better than threats.
Children who refuse to take meds often don’t swallow it on taking, and spit it off as soon as the adults’ attention is diverted. In such cases, resorting to scolding/threatening is more likely to have negative effects.Many young parents resort to pinching the nose to make them swallow the meds. This is another trick that can seriously backfire sometimes. A better way can be to place rewards for the child, if they cooperate and take the medication without messing up. A nice looking black date, currant or cashew nut has mostly worked out well for me in the clinical practice. Take cue from what your child likes and place it as a trophy along with some effective canvasing, to get the wagon rolling.

6. Last, but never the least: Keep meds out of children’s reach.
Children have a tendency to reach out and eat sweet tasting meds just for fun. If you are an 80s/90s kid who is nostalgic of the “sweet yellow-green syrup” (albendazole given under the governmental de-worming programme), you definitely know what it is like. So avoid harmful overdosing by storing meds well out of reach of the kids.

Today is National Children’s Day in India, but goodness never needs the formality of an occasion.

So, how do you plan to put a smile on the face of your little angel today?

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About the Author –
Dr. Harshad Rajandekar is a family physician practising Ayurvedic and modern medicine, based out of Nasik (India). His online/offline consulting schedule can be read here.


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