Helping the Medicine Go Down

Our two-year-old has a medical condition that requires him to take medicine orally twice a day. The fuss he kicks up makes us dread the whole procedure. We seem to have worked ourselves into a pattern of upset which we can't break out of. Any suggestions?

Understanding Your Child's Behavior

It may help you to be less upset if you recognize your child's behavior is normal. Nobody likes putting anything in their mouth that tastes bad - it's nature's way of protecting us from consuming poisonous substances. You're going against what is natural when requiring him to take the medicine. Additionally, your child isn't yet able to grasp the concept that something unpleasant in the short term can be beneficial in the long run.

It's also normal for a two-year-old to resist any form of coercion. If you're forcing him to take the medicine, of course, he'll resist you. At this age, children often resist diaper changes, putting on or taking off clothing, being fed, being told not to touch things, going to bed, and anything else involving an adult deciding what happens to their bodies. Two is the age when a child first begins to want control over their own body, and this desire is both normal and healthy. So, try not to label your child as "bad" or "uncooperative."

Strategies to Encourage Cooperation

1. Make It Sweet, Literally and Figuratively:
   • You catch more flies with honey than with vinegar. If possible, disguise the medicine in something strong-tasting that your child likes. If that's not feasible, apply the principle symbolically by rewarding your child with something they enjoy, like yummy frozen yogurt, to take away the bad taste.
2. Set a Positive Example:
   • Use a role model like Mommy, Daddy, or a Big Sister. Get a bottle of something that looks like medicine and have the role model "take" it, making a face and saying they don’t like the taste but know it’s good for them. Reward them with a treat and ensure they express how much they enjoy it. Then, give your son his medicine and reward him similarly.
3. Empathize and Explain:
   • If your child says they don't like the taste, empathize. Acknowledge that you wouldn’t like the taste either and express that you wish you didn’t have to give him the medicine. Then, provide a simple explanation of why he has to take it, and promise him a reward.
4. Handle the Fuss Calmly:
   • Your child may still make a fuss. During this time, try to ignore as much of it as possible. Avoid arguing with your child. Instead, focus on getting the medicine into him. You might make a game out of it, like pretending the spoon is an airplane flying into his mouth. If necessary, gently force the medicine in, but do so without yelling or spanking. After he swallows the medicine, praise him and give him the reward, without mentioning the fuss he made.
5. Use a Step-by-Step Approach:
   • Gradually change your child's behavior using the role model to demonstrate each stage. Initially, the "patient" might kick up a fuss like your child but eventually swallows the medicine and is rewarded and praised. The role model then progresses to calmly accepting the medicine and getting the reward. Your son will move through these stages more slowly, so be patient and continue rewarding him.

Gradual Reduction of Rewards

Continue giving the reward until your son regularly takes the medicine without fussing. Even then, give it intermittently. Rewarding a behavior intermittently establishes it more effectively than rewarding it every time.