Medication management blog

"How Do I Help My Child with Cancer Take Their Medicine?"

By Allie Neenan, PhD, LP | Last updated 8/29/26

Taking medicine is tough for kids, and that includes kids with cancer. Nobody wants to take medicine every day - so how do we make it easier for the children who need it most?

If you haven't been here before, welcome to Cancer Cushion! Every post on this website is written by licensed clinical psychologist, Allie Neenan. Cancer Cushion is my resource library for every age, role, and stage in the childhood cancer journey. While I wish websites like this weren't necessary, I'm glad you're here.

It is very common for children to have a hard time taking pills or other medications as prescribed. It's estimated that anywhere from 20%-50% of children with cancer miss doses of their prescribed medicines as often as once per week. If your family is navigating this issue, please know you are not alone. It is a Standard of Care for pediatric oncology teams to monitor medication adherence - that means it is their job to ask how things are going and offer advice tailored to your child if things are not going smoothly.

When a medication is needed to save a child's life, it may seem surprising that children struggle to take it. But children are still children. They may not understand why the medicine is so important, even after receiving age-appropriate education. Even when children do understand the purpose of medicine, the taste and feel of it can be very upsetting. Children may also recognize that medications cause painful side effects, which can intensify negative emotions around treatment. None of these challenges is a child's fault or a parent's fault. Families need community support through all aspects of childhood cancer, and that includes any barriers to taking medications as prescribed. Let's explore what some of these barriers are along with tools to address them.

Barrier #1: Not Knowing How to Swallow Pills

Lots of children do not learn how to swallow pills early in life. Unfortunately, many of the medications used in childhood cancer treatment regimens only come in the form of a pill. This requires children to learn a skill that may be above their developmental level, which can be scary. There are evidence-based approaches to teaching children how to swallow pills, and they typically have two main components:

1) Using gradual exposure to help children swallow small candies or placebo pills of increasing size (ideally at least five unique sizes, smallest to largest, until achieving the size of the real pill)

2) Practicing every day for no more than 10 minutes

Even after a child is capable of swallowing the full sized pill, occasional practice with smaller placebos/candies can be helpful for maintaining their confidence. Sprinkles, miniature M&Ms, Nerds, and Smarties are all examples of candies that can be used for this purpose.

Barrier #2: Frustration with Lack of Control

Children with cancer suffer greatly due to losing control over their lives. The daily or weekly medication routines are a constant reminder of the choices that they cannot make with their own bodies. Even the most easygoing, cooperative child may go through stages when they are frustrated by taking medicine. Nothing about the cancer experience is fair, and their feelings are very understandable.

There are many ways to address feelings of frustration and powerlessness. It's important to check in with your child's oncology team if you notice changes in cooperation with medication routines. They may have access to prizes and other interventions to make the process easier.

At home, here are a couple of tricks to try:

1) Let your child have control over what you are doing while they take their medicine. For example, let them choose a song to put on, and then let them tell you how to dance. The sillier you make it, the more likely they are to enjoy it. If you notice your child is stalling after the first song, pause and prompt them to finish the medication before playing a second song.

2) Use rewards with a surprise twist. Each week (or month), sit down with your child and come up with a variety of rewards. Try to use a mixture of "big" (toys, treats, etc.) and "small" (stickers, high fives, etc.) rewards to add in some unpredictability. Write each reward down on a piece of paper and place it in a jar. After each day's medications are complete, let your child choose a prize from the jar.

3) Take "medicine" with your child. Lay out some placebos/candies and let your child tell you which ones to take. Be creative with it - for example, let them tell you to take it with your eyes closed or while standing on one foot. The goal is to give your child back a sense of control and fun.

Barrier #3: Lack of Understanding About Medications and Their Purpose

One of the hardest things about childhood cancer is the decisions that parents must make regarding what to tell children about their illness and treatment. No parent wants their child to be scared about their health. Many children also prefer to avoid talking about cancer. All of these factors can make it hard to know what information children should receive.

In general, children who have less knowledge about the purpose of medications have more challenges with taking medications. Additionally, children who have empowering beliefs about medications have an easier time taking medications. What does this mean in practice? Children benefit from specific, age-appropriate education that highlights their strengths. Examples include:

"When I take medicine, I am taking good care of my body"

"Each medicine has a job in my body, and my job is to take the medicine"

"My doctors chose my medicines because they want my body to be healthy"

Age-appropriate, disease-specific education can be provided by your child's oncology team.

Barrier #4: Not Being Developmentally Ready to Participate Fully

There are aspects of medication adherence that even older children and teens require assistance with. For example, tracking when medications will run out and coordinating refills is an adult responsibility. Balancing medication schedules with other daily commitments is also beyond the capacity of most adolescents. Despite the importance of independence for teens, medication adherence is a complex task that they need support with.

Younger children also have developmental barriers to medication adherence. Education and rewards are not always enough to help children cooperate calmly. In such cases, close consultation with the oncology team is essential for ensuring everyone's safety.

Distraction is one of the most powerful tools available for helping children with distress related to a variety of medical interventions. Distractions can be used before, during, and after medication administration to help lower distress. Songs, videos, and books are all examples of distractions. Transitioning to a distraction immediately after medication administration is complete can help shorten how long distress lasts. For example, you can set up some toys in a separate area immediately before giving medication, then transition into that space as soon as medications are given. Creating a physical separation helps signal that medicine time is "over", which can be particularly helpful for younger children.

The Bottom Line: Medication Challenges Are Not Your Fault

No child or family should have to face cancer or its treatment. If taking medications is a challenge for your child, please let your treatment team know right away. You are not alone, and you deserve support.

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