15 April 2008

Mix medicine into Jell-O Smoothie Snacks to get it down the hatch

Steve's get-the-medicine-in-the-toddler hack:

My 18 month-old had an ear infection and like most toddlers she was prescribed amoxicillin. She has had ear infections when she was younger and we would either give her the medication via syringe or add a little bit to each spoonful of food we fed her. Now that she's a toddler getting her to take her medicine has been a horrific chore.

Sneaking it into her food has limited success since she wants to feed herself and notices the "pink stuff" in her food either by sight or by taste. We were resigned to the fact that we had another week of wrangling our toddler until my wife found Jell-O Smoothie Snacks, Strawberry Banana flavor. The amoxicillin is not visible after mixing it into the Smoothie cup since the colors match. Plus, the flavor is barely noticeable because the strawberry/banana flavor masks it well.

Does anyone know if mixing antibiotics into food changes the potency of the medicine?

More: Best of Parent Hacks: Cold and flu season tips

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There is no risk to the potency of the medicine by mixing it into food. The only potential problem is if the child decides he/she doesn't want to finish the food, then you don't know how much of the medicine they have taken, so you've potentially lost a dose. As an alternative (though still has the same risk as the suggestion above), my pharmacist suggested using the amoxicillin or penicillin as a "topping" on ice cream - apparently being so cold "freezes" most of the taste so the kid doesn't notice - and most kids will eat ice cream no matter what.

Great idea--but I'll add a caution. We were worried about my oldest and pickiest eater not getting enough nutrients. She refused to take a multivitamin, so we bought a liquid one and started mixing it in her juice. It worked great for about 2 months until she caught us doing it. Since then (and it's been a year now) she has refused to drink any juices. Hiding the medicine loses it's effectiveness as they get older.

My daughter has renal reflux and we have to give her 1/2 of a capsule of macrodan each day, splitting it open and eyeballing 1/2 of the powder. It's a pain, but our doctor told us to definitely mix it with food. And you do run the risk of the child sometimes refusing the food, and a wasted dose. We have just started using a teaspoon of cool whip with the white powder sprinkled on top. She doesn't really notice the meds and is so excited to have "ice cream" that she gobbles it up. I wish we had thought of this a year ago!

I have adjusted my behavior so that whenever I get yogurt for my toddler that I take some time to mix it, whether I'm spiking it with medicine or not. The day I give her the yogurt straight from the fridge is the day I can say goodbye to putting medicine in it.

I'm glad to hear that mixing the medicine with food and drink doesn't limit its effectiveness, because the ONLY way I could get my toddler to take his amoxycillin without a wrestling match followed by throwup was to mix it with bottles of Bolthouse Farms smoothies or chai. In our case, there was little chance that he'd miss much of a dose because he loves the stuff and has gotten used to getting a bottle of something (milk, smoothie or chai) early in the morning and late at night. I was a little afraid of the chai taste not being strong enough to mask the meds' flavor, so I would add some additional Oregon Chai mix to his cup to make sure.... and I'd also try to give him smaller volumes of the drinks to help ensure that he'd finish it all.

I *think* that you need to be careful when giving antibiotics and yogurt with live, active cultures. The cultures can reduce the effectiveness of the antibiotic. My doctor has told me that I can eat yogurt while on antibiotics, but not within two hours of one another. I don't know why it would be different for children.

I have to agree with MamaChristy about taking antibiotics and yogurt at separated times. Although many "smoothies" contain yogurt, I notice that these Jello ones mentioned do not, so they should be fine. Basically its the "live and active cultures" that are in yogurt products that counteract the antibiotics. Same goes for frozen yogurt.

I believe there are some medicines that can be mixed and some that cannot be mixed into food/juices. Amoxicillin should be OK with some basic foods, but not yogurt or regular milk. Sulphur based medicines are not recommended for mixing. May want to check with the pharmacist or Pediatrician, as we normally did. My son takes any medicine without a whimper as we always gave him a little taste before the entire dose and that way, he never felt like he was being forced.

May want to try to see if bribery with a popsicle or something fun works if they just take the medicine with the bribe in the other hand. That way they feel they are in control of the situation. Then again there are kids that just WILL NOT take their medications, no matter what you try.

i would open the pill up (i use the powder stuff for this project), put it onto a spoon, then spoon some pudding on top of it. mix slightly, then get the kiddo to eat just that one spoonful. as a reward, he gets to finish the remainder of the pudding cup. but this way i make sure he gets all the medicine first.

Some antibiotics cannot be taken within an hour of having calcium, i.e., milk or milk products. Your pharmacist or doctor will be able to tell you which ones.

MamaChristy: It's actually the opposite; the antibiotics kill the live cultures in the yogurt.

For those who are commenting that this will stop working once kids realize you're doing it, I'd suggest a different approach. If a kid is old enough to "catch" you he's old enough to understand that he HAS to take his medicine one way or the other. So you give him a choice... he can have it mixed up with pudding (or whatever), or he can have it alone, possibly by force, like he's used to.

Full disclosure, I work at FLAVORx. Our business is providing flavorings to pharmacists so they can safely make medicine taste better for kids, so I guess you could say we make a living out of hacking medicine.

Before mixing medicine with any food or juice, you should definitely talk with your pharmacist or at the very least search online for possible drug food interactions. Aside from the potential risk of the medicine interacting with the food/juice, a big concern is that you never know how much of the drug your children are actually getting unless they finish the entire serving of whatever you give them. Feel free to shoot me an email if you have any questions: cbaker(at)flavorx(dot)com

Meagan -
I was thinking the exact same thing...if they can figure out your sneaking it, then they can figure out why they need it. I like the idea that it is their choice how they take it, but not if they take it. Gives them some control over the situation...

My son has been taking seizure medication for about 30 months, since he was nearly three. It comes in a capsule form that you take apart and sprinkle onto food. We use yogurt mostly, although we've also used pudding, baby food and applesauce.

It's a two spoon method: Take one spoon and scoop out the food, use the second spoon to scrape the food level with the edge of the bowl or lower. Sprinkle on the meds (we can fit up to four capsules worth, his current does), and then using the second spoon, dollop on a cover of the food, so it's wrapped up like a sandwich.

He knows that his meds are in it, since the beginning it's been his "yogurt medicine". This medicine is particularly bitter, and this method works 99 out of a 100 times.

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