A–Z of prescribing for children

The palatability of medicines for children needs to be considered, as unpleasant tastes can make drug administration a challenge and have an impact on adherence to treatment (Davies, 2021).

Suspensions – usually particles of pharmaceutical material suspended in a liquid, with sweeteners, flavouring agents and preservatives – can usually help reduce the amount of unpleasant tastes (Davies and Tuleu, 2008). However, solutions, which can include thicker sugary syrups, tend to be a more homogenous mixture that dissolves one substance into another, and may be preferred due to the texture and reliability of dose uniformity (Davies and Tuleu, 2008).

Children's taste buds are recognisable from around 15 weeks' gestation (Northcutt, 2004), and infants are born preferring sweeter tastes (such as breast milk) and have a natural aversion to bitter tastes, resulting in children naturally not being able to swallow bitter tasting medicines. Smell and texture are also important factors to consider as well as taste (Rieder, 2018). Other factors – as well as taste, smell and texture – can also affect medication acceptability, and these variables can often interact with each other (see Figure 1).