Need to know: Address medication refusal by first understanding your child’s reasons 

Taking medication is not easy for kids. Firstly, they need to learn how to swallow a pill; secondly, they may have to deal with some initial side effects; and lastly, they have to come to terms with the fact that taking medication makes them different from their peers.

If your child is at the point where they may refuse to take medication, the first and most important step is to ask them why they won’t have it. This approach removes any guesswork and is a good way to get your child involved in brainstorming a solution. 

A guide to understanding why children may refuse medication

We’ve collated a series of successful strategies used by other parents when they were faced with their child’s medication refusal. Hopefully, you will find one or a combination of strategies that work.

Reason 1: Doesn’t like the taste 

• Disguise the taste. This is probably one of the easiest concerns to address. If the medication can be crushed, add it to a smoothie or yoghurt. For an option that is quickly consumed, mix the medication on a spoon with their favourite jam, honey, or Nutella. 
  
  
• Put it in a capsule. If the medication can only be cut and not crushed, you can purchase empty veggie or gelatin capsules in different sizes from a chemist. Talk to the pharmacist about which one is the best fit for the medication you have. 
  
  
• Cover it in a special flavoured gel. The other option is a product called Gloup, which is a slippery gel that enables you to swallow your medicines easily and assists them in passing smoothly through the oesophagus to the stomach. This lubricant also comes in a couple of flavours that hide the medication’s natural taste.

Reason 2: Doesn’t like how it makes them feel

• Be a detective. During the first couple of weeks of trialling a new medication, a child might feel out of sorts, but their concern is always one to take seriously. Pick a couple of times to talk to your child about how they are feeling, preferably after the medication takes effect and after it metabolises.
  
  
• Talk to your paediatrician. If you believe that something is not quite right it is best to talk to your paediatrician about your child’s concerns and discuss your options.

Reason 3: Doesn’t think it does anything

• Find out what else is going on. There are many reasons why a child may refuse to take medication but unless you can prove that the medication is indeed having a positive effect, this requires further investigation. Talking to your child about their challenges before and after medication is a good place to start. You might be surprised by what your child tells you.
  
  
• Collect evidence. Medication is not going to fix everything but it can help in many ways. Your child might just need to be reminded of the positive changes and be given the opportunity to talk about how to address the outstanding challenges.

Reason 4: Doesn’t want to be different from other kids

• Explain why they take the medication. Sometimes kids need reminding why they need to take medication. You can explain what the medication does for them or, depending on your child’s age and cognitive ability, find a YouTube explainer video suitable for kids that they can watch. 
  
  
• Show them they aren’t that different. There are many examples of children who have to take all kinds of medication, some need it for asthma, others need it to control diabetes, some need medication for seizures and lots of kids take daily vitamins. Showing your child that many children take different medications can help them feel better by demonstrating that they aren’t that different after all.
  
  
• Revisit the medication timing. If your child is taking their medication at school, they might feel exposed to their friends. Talk to your paediatrician about timing options so that your child can take their medication at home.

Reason 5: Doesn’t know and can’t sit still to explain

Sometimes there is no real reason, it comes down to your child being dysregulated and getting stuck in their thinking.

Here are some strategies to help your child get unstuck from their negative thought process:

• Trigger natural dopamine first. Start with something that creates natural dopamine before attempting to give your child their medication. Include music, playing chase, fixing them a yummy drink, etc, in your medication routine
  
  
• Make it a game. Will it be a tic tac, a sultana, or the medication? If you take medication or vitamins you can make it a race to see who can take their respective medications first.
  
  
• Try it while they are distracted. Sometimes making too much of a fuss puts too much focus on the actual process. Observe your child and pick a time when they are distracted doing an activity and give it to them without drawing unnecessary attention to taking the medication.
  
  
• Offer a reward. Write down different rewards on paper (obviously short and within reason), place them in a little bag /empty tissue box, and encourage your child to pick out a reward after they take their medication. The variable nature of the rewards creates more dopamine because of the added anticipation.
  
  
• Give them time to process. Sometimes all children need is a little bit of time. Prepare the medicine, a drink, and a treat at the same place and at the same time every time. Tell your child the medication is there for them to take when they are ready.
  
  
• Break the cycle. It’s easy for a child to get stuck in a negative pattern of thinking. Break the cycle by changing the routine, trying a different time, doing it in a different room, or asking the other parent for help. 
  
  
• Offer a choice. Kids are much less combative when they feel like they have a choice. Would you like to take your medication with a glass of milk or apple juice? Would you like to have your medication now or after you get dressed?

You got this!