Hi Julie - Yes I always made my son sit up and now he absolutely must take it with milk  because a couple of years ago he had horrific problems with stomach distress. After GI doctors visist, found out it was the cortef! After an ample amount of time on Pepcid AC, his stomach healed and have always made sure now that he has a full tummy or has cortef with milk. Immediately following, noticed when picked up prescription from pharmacy that they had begun putting label on bottle : "Take with food or milk". So I asked the pharmacist and he said that the company had finally realized that cortef was very hard on the stomach and your tummy must be either full or coated with milk to avoid problems. A little late! Just thought I'd mention that  in case anyone is giving their child the pill with water during nighttime hours on an empty stomach.