Background Bitter taste receptors are genetically diverse, so children likely vary in sensitivity to the “bad” taste of some pediatric formulations. Based on prior results that variation in a bitter taste receptor gene, TAS2R38, was related to solid (pill) formulation usage, we investigated whether this variation related to liquid formulation usage and young children’s reports of past experiences with medicines and whether maternal reports of these past experiences were concordant with those of their children. Methods We conducted retrospective interviews of 172 children 3 to 10?years old and their mothers (N?=?130) separately in a clinical research setting about issues related to medication usage. Children were genotyped for the TASR38 variant A49P (alanine to proline at position 49). Children’s responses were compared with their TAS2R38 genotype and with maternal reports. Results Children (>4?years) reported rejecting medication primarily because of taste complaints, and those with at least one sensitive TAS2R38 allele (AP or PP genotype) were more likely to report rejecting liquid medications than were those without a taster allele (AA genotype; χ 2 =?5.72, df?=?1, p?=?0.02). Children’s and mothers’ reports of the children’s past problems with medication were in concordance (p?=?0.03). Conclusions Individual differences in taste responses to medications highlight the need to consider children’s genetic variation and their own perceptions when developing formulations acceptable to the pediatric palate. Pediatric trials could systematically collect valid information directly from children and from their caregivers regarding palatability (rejection) issues, providing data to develop well-accepted pediatric formulations that effectively treat illnesses for all children. Trial Registration Clinicaltrials.gov protocol registration system ( NCT01407939 ). Registered 19 July 2011.
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