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Health Information Blog : Double Duty
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I'm a pediatrician by training with an undergrad degree in journalism. I spend my days teaching and mentoring future pediatricians. My wife and I spend our evenings and weekends keeping up with very active twins. This blog will chronicle my thoughts on current children's health care issues and trends, trials and tribulations as a parent and husband mixed in with a lot of life experience.


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About Our Author

photo William Stratbucker, MD
Monday, July 26, 2010
Tips for Masking and Chasing a Medicine's Taste
by William Stratbucker, MD at 10:12 AM

Diane Sinsabaugh is a Clinical Pharmacy Specialist in Pediatric Oncology/Bone Marrow Transplant at Helen DeVos Children's Hospital. She is our guest blogger this week.

When most parents find out their child has an illness requiring frequent medication, one of the last things they think about is how the medicine will taste to their child. But for many kids, concerns about the taste-sometimes even more so than the actual disease or illness-is what they think about most.

As a registered pharmacist, I've been aware of this since early in my career, and am always on the lookout for ways to educate parents and help kids who must take medicine that has a bad taste-after all, if a medicine tastes bad, children won't want to take it, or worse, may find a way to fool their parents into thinking they've taken it, when actually they haven't.

That leads me to my first and most important point: being straightforward is what is best when it comes to giving your child medicine. Therefore, one of the things I strongly recommend is to never trick a child into taking a medicine-for one, it will only work once, but for another reason, it will likely leave your child angry, distrustful, and perhaps even less secure.

What I recommend is to mask a medicine's taste and include your child in the process, so he or she can help pick flavors-this works much better than mixing medicine with mild tasting foods or in water. Any flavors that your child likes may work, but first get a sense of whether the medicine has more of a salty or sweet taste. If it is salty, choose a flavor that complements a salty taste like tomato juice, soup broth or tortilla chips. Vice versa, if it's sweet, go for a sweet masker.

I like to give maskers and chasers "themes" to help make the experience more positive for kids, and I'm sure you can come up with a few of your own. Here are a few masking ideas:

  • "A Kid'll Eat the Middle": Most kids like eating the cream inside a sandwich cookie first Therefore, put the medicine inside the cream and so your child can eat it first, and follow up with the hard cookie "outsides."
  • "Go Greek": Remove the pimento from a green olive, insert a pill then replace the pimento.
  • "Ice Cream-less Sundae": Coat a pill with a thick chocolate, cherry, strawberry, caramel or butterscotch topping.
  • Some medicines have such a strong taste, that they really can't be masked. In these cases, I recommend "chasing" them with a favorite flavor. A few suggestions:
  • "Thin Mint Sans the Scout": Put the medicine in chocolate syrup and chase it with peppermint candy.
  • "Reese's Re-Mixed": Put the medicine in peanut butter and chase it with chocolate.
  • "S'mores Without a Campfire": Put the medicine in marshmallow cream and chase it with chocolate sauce and graham crackers.

It's important to know the perception of taste tends to be much stronger for liquids than solids. So, if the pharmacist gives you a choice between a solid tablet or a liquid formulation, choose the tablets. They will be much easier to "mask."

I also have just a few final thoughts I'd like to leave you with regarding young children:

  • Very young children are often extremely motivated to learn how to swallow capsules to avoid a bad taste. Kids can practice swallowing using mini-sized M&M's or "Nerds."
  • "Pill glide" is a fruit-flavored spray you may want to try, which helps make swallowing tablets and capsules easier.

Even if your child does not need medicine now, chances are at some point, he or she will, so I hope you keep these tips in mind for when that comes. Your child is sure to thank you for it.

- Diane Sinsabaugh, RPh

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Thursday, July 15, 2010
Kids and Body Image
by William Stratbucker, MD at 07:55 AM

Kids and Body Image

Dr. Cadieux is a child psychologist and this week's guest blogger.

 Media portrayals of unrealistic or unhealthy body images, sometimes through use of computer technology to make a model look thinner or improve "flaws" is bombarding our children with ideas of how their bodies should be.

Children and adolescents definitely pick up on these messages. Kids of all ages and sizes can adopt a negative body image and believe they must strive to make their bodies "perfect." It's also important to recognize that increasingly more and more boys are having issues with body image. And, of course, peer pressure continues to plays a significant role in how your child views his or her body.

I'm going to share some good news in a moment, but for now, here are some sobering statistics:

  • Half of all girls and a third of all boys use unhealthy weight management strategies
  • 81% of 10-year-olds report that they are afraid of being fat
  • 46% of 9-11 year olds are "sometimes" or "very often" on diets

But, before you become too discouraged, consider this: as a parent, you hold an enormous influence over your child, and therefore, your own attitude towards weight and body image will likely be the greatest influence on your child's beliefs about these topics. You can make a difference. That's important to remember.

That said, we all know most children don't want to be told what to do-and they usually listen best when we think they aren't listening. That's why, instead of lecturing your child, one of the best ways to help your child maintain a positive body image is to be aware of what you say about yourself. If you're a mother, do you sometimes make negative remarks about your own body and say you look or feel fat or need to lose weight?  If you do (and 80% of all women report that they are dissatisfied with their bodies, so it's likely you've got company), just keep in mind that your child is more likely to take on a negative view of his or her own body, too.

Of course, I also hope it goes without saying that any negative comment a parent makes about his or her child's body, or other people's bodies, can have a negative impact on the child. So, even if a child is overweight, a parent should never use negative comments to try to "help" the child to lose weight.

Here are some ways you can encourage a positive body image in your child:

  • Be accepting of your own and others' bodies
  •  Pursue your own individual and social activities, try new things and encourage your child to do the same
  • Offer positive comments to your child about their characteristics, abilities, efforts
  • Focus on effort and improvement in yourself and child, not perfection
  •  Pick up a magazine, and talk about and challenge messages being sent through the advertisements
  •  Eat healthy, and limit, but do not eliminate low-nutrient "junk" foods
  •  Be physically active with your child

Remember: Your attitudes and behaviors are probably the biggest factor in how your child will view his or her own body. Make sure your child knows that while maintaining your health is important, body shape or size does not determine happiness, self-worth or success. When you send your child these positive messages, everyone wins.

- Dr. Cadieux

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Wednesday, July 07, 2010
Using Medicine Safely
by William Stratbucker, MD at 02:13 PM

Morgan Cole, PharmD, is the pharmacy manager at Helen DeVos Children's Hospital. He is our guest blogger this week.

Giving kids medicine safely can be a complicated task. It's possible to give your child medicMorgan Cole, PharmDine safely and prevent dangerous reactions with knowledge and double-checking.

Using medications safely means knowing when they are necessary, as well as when they are not. Always check with the doctor or pharmacist if you are unsure whether medication is necessary.

In many cases, supportive treatments may be the best bet for a quick recovery, especially with cases of the flu or the common cold. Getting enough rest will allow the body to heal, and plenty of clear liquids will help your child avoid dehydration from body fluids lost through vomiting, diarrhea, perspiration and nasal secretions.

To ensure the safe use of prescription or over-the-counter (OTC) medicines, discuss your child's allergy symptoms with your doctor and pharmacist. Once treatment has been established, you should know:

  • The name and purpose of the medication
  • How much, how often and for how long the medicine should be taken
  • How the medicine should be administered
  • Whether the medicine be taken with or without food
  • How the medicine should be stored
  • How long the medicine can safely be stored before it needs to be thrown away
  • Common side effects or reactions
  • What happens if your child misses a dose

Dosages of prescription and OTC medicines depend on a child's weight so make sure the doctor and pharmacist have current information about your child. Too little medication can be ineffective and too much can be harmful.

Sometimes medicine should be given on an as-needed basis. OTC drugs that relieve symptoms such as aches, pains or fever should only be taken as recommended. We do not recommend OTC cough and cold medicines such as phenylephrine, pseudoephedrine, dextromethorphan, etc., be given to children under the age of 4 years.

In most circumstances acetaminophen is preferred in children to treat fever and pain. Generally speaking, never give aspirin to children, unless prescribed by a physician.  Using aspirin during an illness caused by a virus (such as the flu, chickenpox or an upper respiratory infection) can cause Reye syndrome, a potentially life-threatening disease with symptoms that include nausea, vomiting and extreme fatigue that progresses to a coma.  Some OTC medicines contain aspirin, so it's important you read labels and check with your doctor before using them. Be aware that some aspirin-containing medications use words other than aspirin such as salicylate or acetylsalicylic acid.

However, many medications should be taken until finished as prescribed by the doctor - even if your child begins to feel better.  Antibiotics help to kill bacteria in the body, so it's important to finish all doses even after symptoms disappear because the infection can return if the antibiotic is stopped too early.

Other tips I like to share with parents who are worried about using medication correctly include:

  • Don't try to diagnose your child's problem yourself. Always check with your doctor if you're unsure whether symptoms require medical treatment. You may also look at "Should I Call the Doctor?" on our Web site.
  • Never use leftover medications. For example, doctors may prescribe or pharmacists will sometimes dispense more liquid medication than is needed in case some is spilled or measured incorrectly. If you have liquid left over after your child has completed the course of treatment, throw it out. For medicines taken as needed, pay attention to the expiration date to make sure you are not giving an outdated medication.
  • Never give your child medication that has been prescribed to someone else. Even if two people have the same illness, they may require different drugs with different doses and directions.

  • If you're purchasing OTC medications, check the packaging for possible tampering, and don't use medications in cut, torn or sliced packages.

I also encourage you to develop a relationship with a local pharmacist so that your family's medication history is in a central location. Your pharmacist and pharmacy are an extension of your health care team and play a vital role in the health of your child.  

- Morgan Cole

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