#1 medication hack for administering medication to kids with feeding tubes

Today we’re talking about giving medication to kids through a feeding tube and the number one hack we’ve found for making the medication administration process easier.

Our son is like a lot of children with special needs in that he requires a fair amount of medication, both prescription and over-the-counter.

When he got a feeding tube many years ago, all his medication was in liquid form, or if a medication didn’t come in liquid form, it had to be compounded at a specialized pharmacy  to be given in liquid form.  This was pretty painful for several reasons:

1. We had to go to different pharmacies for regular vs. compounded medication.
2. It’s often hard to pull liquid medication out of its container with a syringe.
3. A lot of medication is wasted over time when you pour liquid medication into a medicine cup to draw it into the syringe and then pour the excess back into the medicine bottle; we would often run out of medication before insurance would process a refill.
4. There can be variation in dosage, both from user inaccuracy pulling the liquid meds and, in the case of compounded medication, not shaking the medication well every time.
5. There is some anecdotal evidence that liquid medications can be slightly less effective than in tablet form, possibly for the reasons I just listed.
6. The process of pulling liquid medications several times a day is messy and time consuming.

The alternative for most medications is to get the medication in a tablet form, crush the tablet, mix it with water and draw the liquid up into a syringe.  While this method has some benefits, it is still messy, time consuming and you can get small variations in dosage depending on how well you’re able to draw all the medication into the syringe.

But we developed a hack, and I’m sure someone else along the way has figured this out as well, but I am always surprised when we show doctors and nurses this trick that they’ve never seen it before, because it’s so simple. This hack has allowed us to substitute almost all of our son's  liquid medications (except one) with tablets, including things like Tylenol and Advil/motrin.

One caveat: The medication technique discussed here can only be used with medication tablets that can be crushed.  Almost all of our son’s medications, include over-the-counter medications, can be crushed.  But certain medications, particularly extended release tablets (which have a special coating or are designed to dissolve slowly over time), cannot be crushed.  Tube fed children typically are not prescribed extended release medications, because that format is typically incompatible with a feeding tube.  Before you explore this idea, however, you do want to check with your child’s doctor or health care practitioner to make sure any medication your child takes can be dosed in a tablet form and can be “crushed”.

So on to our medication hack!

Step 1:
Remove the plunger from the syringe
Step 2:
Drop the tablet into the syringe and replace the plunger
Step 3:
Draw water into the syringe

The medication typically dissolves within a few minutes.  Medication will dissolve more quickly if we use warm water and, with a couple of the thicker tablets, we snap them in half on the score mark which also helps them to dissolve faster.  This technique is quick, clean, and we know we are consistently giving the same dose of medication each time.  We no longer have medications compounded and the tablets take up much less space than the liquid counterparts. We also use this technique with Tylenol and motrin.  If you have a baby or young child with a feeding tube, there are dye free chewable pain reliever tablets that should dissolve in this same way, so you may want to explore this option for smaller children.

And just a final thought on medication.....we always use dye-free medication whenever possible. Both of our children become irritable and have other significant behavior changes with food dye. In Europe, food dyes have largely been abandoned in products and food for children and require a warning label for these reasons (see the link here), but the US is a bit behind in this regard.  Dyes are often added to children’s medication to make the medicine more palatable (or fun) for children, but they serve no therapeutic purpose and, in our case, actually cause harm. We find we have to be particularly careful with dyes added to liquid pain relievers, antibiotics and steroids.  Most OTC medications have dye-free options and we have a note on file in our children’s file at the pharmacy not to add any dyes to prescribed medications.

I hope this medication hack may give you some help and ideas for your own medication administration.

Please leave a comment or ask a question and I’d love you to tell me if there are other topics you’d like me to cover in future videos!