The pharmaceutical treatment of disease has obviously improved a lot in 50 years but that doesn't mean kids like the taste of medicine.

Does that mean kids won't take it?

Perhaps they won't take it, if you are the worst parent ever, but a review in Clinical Therapeutics takes the issues out of folklore and highlights recent advances in the scientific understanding of bitter taste, with special attention to the sensory world of children. 

Several biological factors highlight the importance of understanding bitter taste to the successful formulation of pediatric medications. Bitter taste is thought to have evolved as a protection against toxins, as many poisons taste bitter. Because of this, it is very difficult to disguise or mask bitterness. Compounding this problem is the fact that children, who are especially sensitive to bitterness, cannot swallow pills or tablets, which encapsulate bitterness in adult formulations.

The review of studies is a summarizes current knowledge on how bitter taste works from a biological perspective. In addition, the paper provides a comprehensive overview of methods used to assess taste responses in children. The authors point out critical gaps in the existing understanding of how best to measure bitterness in children, whose cognitive and perceptual abilities differ from those of adults.  Plus, all methods of measuring responsiveness to bitter ligands, in animal models through human psychophysics or with “electronic tongues”, have limitations.

"The problems associated with pediatric drug formulations are enormous and can hinder optimal therapeutic outcomes," said lead author Julie Mennella, PhD, a developmental psychobiologist at  the Monell Chemical Senses Center. "Both the complexity of bitter taste and the unique sensory world of children contribute to this critical issue."

Citation: Julie A. Mennella, Alan C. Spector, Danielle R. Reed, Susan E. Coldwell, 'The Bad Taste of Medicines: Overview of Basic Research on Bitter Taste', Clinical Therapeutics 24 July 2013 DOI: 10.1016/j.clinthera.2013.06.007