Thursday, January 14, 2010

How do you give an infant a pill?

One of the least scary things we learned before Megan was discharged from the NICU was that she had hypothyroidism. It's simple to treat, they assured us. Just give her medicine once a day and she will not have any problems as a result.

This was much easier to swallow than the heart problems. But this is the first problem that really set me on a mission. Even though it was so treatable, I next learned that the hormones from the thyroid are responsible for BRAIN DEVELOPMENT in babies! (I was thinking it was weight gain. I could live with messing up a little if it was just that, but brain development! Why did that have to be something I could actually ruin!?!)

How do you give an infant a pill?

It seemed so simple. You split it to the proper dose, crush it in a pill grinder, pour it in a little cup and add some water or breast milk... WRONG! Most of the pill is now sticking to the sides of the little cup. (This is what they did in the NICU. The endocrinologist did not agree with this method.)

So you split it, crush it, mix it in a bottle, add a little breast milk or water... WRONG! It sticks to the sides of the bottle.
Even if you use multiple washes of milk or water, it still sticks (I tried).

So I did what any reasonable mom would do, I asked her specialist what to do. He was so helpful with what I should not do. He said "You should put the crushed pill onto a teaspoon of milk or water and shove it in her mouth." This man (nice though he admittedly was) had definitely never tried this method.

I had no idea she could spit something out so quickly, so completely. Megan said that this method was WRONG! (I held a grudge against that doctor for his terrible advice and she goes to a different endocrinologist now.)

So my husband and I searched for a better idea. We didn't find anything.

Finally, by trial and error, I found the answer. Here it is:

Required tools:
Oral syringe (I recommend the Safety First syringe because it has a wide flare for the top opening.)
small cup
clean hands

1. Take the syringe apart.
2. Put your finger over the opening of the syringe (the part that goes in their mouth) and hold it tightly.
3. Pour the medicine into the syringe from the top. (Keep it upright.)
4. Gently push the stopper just a little way into the syringe.
5. Flip the syringe so the powered medicine can fall down onto the stopper. (Flick the sides if necessary, but make sure there is no more medicine against your finger.)
6. Remove your finger.
7. Keeping the syringe upright, insert the stopper slowly until it is most of the way into the syringe.
8. Suck up some liquid (breast milk was great for keeping her from spitting out the medicine because it was a familiar taste, but it did not dissolve the pill well. We switched to water once she liked water too.)
9. Put your finger firmly over the end again
10. Shake it up
11. Give it to the baby
12. Repeat 8-11 as a rinse

Some other tips:
Don't clean the pill crusher. It sounds gross, but it helps keep the dosing consistent. Just be careful to keep it in a special place out of the way of the dirt of life. When we had multiple pills to give her we used separate pill crushers for each one.

Megan went through a stage of spitting out her medicine no matter what we mixed it with. Finally we realized that she just didn't like having anything squirted into her mouth. We started leaving extra air in the syringe and letting her suck the medicine out. It worked great for her. It also taught her how to drink out of a straw at a very young age.


  1. Thank you for this post. We are starting this journey with our youngest and it is way harder than I thought.

  2. Thank you for this post. We are starting this journey with our youngest and it is way harder than I thought.