By Chris Swingle
Rochester (N.Y.) Democrat and Chronicle

Your child is miserable with a cough or ear infection, and you're trying to get her to swallow some medicine.

"No! Not the red stuff!" your daughter cries, hiding under the covers, refusing to open her mouth.

Even Dr. David Breen, a pediatrician in Dansville, N.Y., has been there. "I have a terrible time with my own children," Breen says. He has struggled to hold down his 2-year-old son for antibiotics to relieve the boy's ear infection.

"He threw such a fit," Breen recalls. "It was literally bordering on child abuse, forcing him to take it."

Offer a chaser, reward

Finally, the frustrated parents took their son back to his own pediatrician for one dose of an injected antibiotic, which took care of the ear infection.

Hollise Brown of Perinton, N.Y., remembers straddling her young sons on the floor, their arms pinned, and using a plastic syringe to get medicine down their throat.

"They don't like that," she says, in that understated way that parents look back on certain traumatic family experiences. But her resolve wore them down, the mother of three says. Now, "They give in."

She keeps a glass of cold water ready as a chaser and lets her sons have a piece of candy or a cookie afterward.

As viruses and strep throat sicken people young and old this winter, pediatricians, parents and pharmacists say there are some strategies that can help get medicine into children who need it. From flavoring the dreaded medicine to going back to the doctor for an alternative, parents have options that don't include straitjackets.

Pharmacists can now add one of 42 flavors - from bubble gum to mocha cappuccino - to liquid medicines, powders or pills.

FlavoRx, marketed by a Bethesda, Md., company of the same name, is available at about 12,000 pharmacies nationwide. Its slogan: "We make medicine a lot less yucky."

"I think a lot of people don't know about it," says Gail Kaiser, pharmacist in Greece, N.Y. She's had only a dozen requests in the two years she's carried it. A manual tells her how to flavor or reflavor more than 200 different medications, even over-the-counter ones. The Tops Pharmacy where Kaiser works charges $3.49 for the service.

Tricks with flavorings

There are also some flavoring tricks parents can try at home.

Try chilling a liquid medication. "It cuts down on the bitterness," Kaiser says.

Patients find that even liquid amoxycillin, which tastes OK at room temperature, tastes better chilled.

Some experts suggest mixing syrup - chocolate, strawberry or even pancake syrup - with liquid medication.

When it comes to over-the-counter cough and cold formulas, families find that palatability varies by brand. Brown says her kids like the grape Dimetapp allergy elixir but not the grape Robitussin expectorant or the cherry Dimetapp DM.

For an infant, a medicine dropper can do the trick. Dr. Syed Masood, a Rochester, N.Y., pediatrician, presses his finger into a baby's cheek to keep the baby's gums separated, then squeezes in a few drops at a time toward the back of the mouth. The babies don't like it, but they do swallow.

Older children can have more control. Ask them how they'd like to take the medicine and explain what the medicine is for.

Get correct dosage

Avoid the common mistake of dispensing medicine with the bottle cap or a soup spoon from the kitchen drawer. They vary in size too much. To dose the proper amount, use a medicinal spoon marked in tablespoons or teaspoons.

Pills can be more difficult because they're literally harder to swallow.

Small pills can be put in some applesauce, pudding or even a spoonful of ice cream - as long as they can be taken with dairy products. Most bigger pills can be crushed and mixed in a little food, but check with your pharmacist first.

Time-release pills, such as attention-deficit disorder medication, shouldn't be crushed, cautions Masood.

But, he says, some time-

release medications are now sold as capsules that can be opened and the contents sprinkled onto a small amount of applesauce.

If all these strategies fail, consult your pharmacist or pediatrician. Sometimes a better-tasting drug can be substituted.