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When doing biomedical intervention, it consists of multiple tablets, capsules and liquid supplements. The child has to take up to 20 different supplements a day, for some many more. And getting your young child to take it all is a herculean task, even more difficult when dealing with a child with Autism Spectrum Disorder. No amount of rationalizing, bribing, encouragement and begging would force our kids to open their mouths, and if they do, they end up spitting it in your face. Some children including Maya are so resistant to taking anything remotely suspicious, their long-term feeding issue makes taking supplements even harder. And I don’t blame her, those supplements tastes horrible!
When first starting biomedical, we had a really tough time with Maya. We found out very quickly that ‘tough love’ did not work with her whenever we forcefully fed her with the supplements. Apart from spitting, she would usually end up vomiting everything in her tummy, she would cry and rage for a long time.Because our girls are physiologically too young to be able to swallow capsules and tablets, we end up opening a capsule and dissolving it into milk or juice. Previously I would grind up tablets in my lesung tumbuk, however I have since found pill crushers which grinds it up into a very fine powder. We tried feeding the liquid supplements with a spoon, but that turned out to be a disaster too. She would knock the spoon out of our hand, precious supplements flying everywhere.
We experimented by mixing and hiding it in milk or juice. Tried different coloured sippy cups, drinking from a straw, only putting in 1 capsule into a big bottle of milk, hiding it in rice, mixing into peanut butter, mashed bananas, we tried everything. It took us a long time to find a groove; we now know which supplements are better tolerated taste wise in milk, which ones are better in juice. Maya is very sensitive to taste, she would refuse to drink the milk constantly when we added in supplements. We wasted so much money, milk and supplements down the drain. We would start very slowly, adding just 1 supplement to the milk, and at only a quarter of the dosage. We would then slowly build up the amount till she can tolerate the whole dosage. Then we would add on a 2nd supplement and start at 1/4 dosage. This worked very effectively for us, we can now add 3 to 4 supplements into 1 bottle of milk.
There are supplements that turns the milk pink or green, we would give these supplements in milk in the middle of the night while they are asleep. We also find that the girls are more tolerant of stronger tasting supplements when drinking it in milk when they are deeply asleep. We take turns to feed the girls their milk at midnight, for now this is what works for us.
I have melted precious organic gfcf chocolate, mix into some rice crispies for some crunch and add the supplements in. And chill them in tiny paper cups like candy. It worked beautifully for 1 day. The next day onwards she refused anymore chocolate. Because both the girls don’t like soft slimy food, I couldn’t try adding supplements to jelly. One desperate day, I mixed some of the more bitter supplements into ice cream – this worked the best! However, there are no GFCF ice cream available in Malaysia so the thought of giving Maya dairy-filled ice cream everyday went against our GFCF principles. I’m still considering buying an ice-cream maker, hopefully I can create a delicious homemade GFCF ice cream.
I bought a box of colorful straws and this worked wonders in getting Maya to drink the supplements mixed with juice in a cup. Everyday she would request for a particular colored straw and will happily drink the supplements. She may not drink it all in one go, we would still have to chase her around the house and coax her to drink it all up bit by bit. Slow but steady I say.
We enlisted the help of our wonderful ABA team to start a tolerance program for taking supplements with a syringe. We supplied the team with a large box of 5ml syringes and the team got to work. After a couple of months into the program, it seemed to me to be a complete waste of time and precious syringes. Maya would only tolerate taking water from a syringe if it was from a therapist, she refused to do it with us at home. It has now been 3 months since Maya started the program and this week we managed to give her supplements in a syringe! We have managed to give her 3 different types of supplements in a syringe, but there are still 20 more to go. Perhaps next year we will do a program to teach her to swallow tablets using ABA.
Maya has always had an intense fear of syringes, ever since very young. She would run away screaming whenever she saw a syringe, she would be so scared and agitated she was inconsolable. We still have to smuggle in supplements in milk bottles at midnight, however there has been great progress.
For any parent feeling frustrated trying to figure out how best to administer these many supplements, only know that the gains and benefits are enormous. Every precious supplement that you successfully manage to give your child is another step closer to improving his health and mind. By being creative, consistent and resilient, you will find what works best for your child.
Don’t feel discouraged, you can’t compare your child to Maya. Don’t compare your child to the neighbor’s son who learnt to swallow tablets at 4 years old. Don’t compare your child to your nephew who’s compliant and meekly takes any vitamin given to him. Each child has their own preferences, each child has their own diagnosis to battle with. Also remember that it took us 9 months to get to where we are now. It has been some time since Maya rejected a milk bottle complaining of the taste. I feel an enormous sense of pride for Maya, allowing us to put the much hated syringe in her mouth and swallowing those nasty tasting supplements. She is the one who has worked the hardest, her accomplishments and improvements are testimonial to her strong spirit and amazing strength.
Spectrum Mum in Malaysia 
>Fruit is ok, juice is not. Juice is pure sugar, stripped of fibres. It's asking for trouble.Try making fruit smoothies instead of ice-cream. Or santan or soymilk ice-cream.Diarrhea – take probiotics every 30 mins until ok. Tried it once and it worked!I don't know if your girls are too young to do this, but I take horrible liquid supplements by pushing the straw to the back of my throat, then the liquid goes straight in, bypassing my tongue.See an OT about reducing mouth/tongue sensitivity. There is a vibrating toothbrush thingy (with no bristles) that helps to desensitise the mouth. You can also use a finger or a finger wrapped in a hanky. Just sweep it over the mouth, tongue, lips. This would reduce texture sensitivity.Incidentally, I saw a boy who voluntarily ate a leafy veg for the first time in his life (age 7) – his mum almost fell over – after he started taking nystatin. Another 3-yr-old allowed her mum to put a toothbrush in her mouth for the first time also after starting nystatin. I wonder if you might see the same if you get the yeast under control.
>Hi PS, Thanks for the comments and suggestions. I make very diluted juice, 1oz juice + 8oz water. My girls absolutely hate smoothies. They also have soy intolerance. How our kids take their supplement is unique to every child. My daughter only able to drink from a straw 4 months ago once her yeast issue has cleared. We can now give some supplements with a syringe.
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