Learning to swallow pills

Author: Alison Johnson

Making the switch from liquid or powdered medications to pills can be tricky for a child. Many kids will gag or have trouble swallowing, especially if their throat tightens due to a fear of choking.

But kids as young as 4 can learn to swallow pills (toddlers and some preschoolers are at too much risk of choking), although others still struggle with the skill into their teenage years. A parent's best bet: begin practicing when the child isn't sick, doctors say. "Start with teaching them to swallow small pieces of candy," says Dr. Phillip Snider, a physician with Bon Secours who practices in Norfolk. 

Parents can introduce the skill by using something as small as a sprinkle or grain of rice, then go on to Tic-Tac breath mints, mini M&Ms, cut-up gummy candy or pill-sized pieces of apple. (Just make sure the child understands that food and medicine aren't the same thing, and he shouldn't ever take more than the suggested dose of medicine).

It's important to be patient and positive, and to not force kids before they're ready, Snider says. "Make sure they understand why they need the medicine," he adds. "Don't say, 'It's time for your medicine.' Instead, ask them what flavor drink they want to take it with. Also, putting a little yogurt or liquid in their mouth first helps with taste."

More tips:

-- Have a child take a few sips of water or juice before taking a pill, because a dry mouth makes swallowing more difficult.

-- DON'T tell the child to throw his head back. Contrary to what many people think, that motion/position actually closes the esophagus, or swallowing tube. Instead, the child should slide the pill to the middle or back of his tongue, slightly dip his chin toward his chest and take a sip of a drink to wash it down.

-- Pick out a favorite drink to help wash the pill down, even if it's something usually forbidden such as soda.

-- Help the child stay calm if the pill feels "stuck." Just have him keep drinking, while reassuring him that the feeling will disappear soon.

-- Try having the child drink through a straw to swallow the pill; focusing on the straw can be a good distraction. Or have him take a huge gulp of water, swirl it around several times and then swallow. 

-- If a medication can be taken with food, have a child take a bite of a favorite treat, chew it up and then add the pill to his mouth just before he swallows. Or stick a pill inside a cube of Jell-O, spoonful of pudding or small mandarin orange segment, which kids can swallow whole.

-- Ask a doctor or pharmacist if a medication can be chewed, or crushed/broken and then mixed into a favorite food. Also find out if you have a choice between a tablet or capsule. Capsules, which are lighter and tend to move more easily to the back of the mouth, often are easier for kids to manage. 

-- Try having the child stand, not sit, while taking a pill. That can help with swallowing.

-- If a child refuses to take medicine, try not to get angry. Count to 10 or take a five-minute break.  

-- Dole out lots of praise when the child is successful -- or even when he's not, if he's given it a good try. On the other hand, don't make a child feel bad by saying liquid medicines are for babies, which will strip his confidence. 

Luckily, most kids will do fine once they know the "feeling" of swallowing pills. Kind of like riding a bike!