Saturday, July 26, 2014

Getting kids to swallow pills

Kids fighting to take medicine is a commonplace occurrence. They don't like the taste. They're already sick so they don't want to do anything you want them to do. They want to wait 5 more minutes. There are as many reasons they don't want to take it as there are reasons we think they need it.

swallowing pills, medicine, capsules, tablets

One of the biggest challenges for some people (not just kids) is swallowing pills. At some point transitioning to pills is important. They are easier to store. Some medicines do not come in liquid or chewable form. Some kids simply get so big that the volume of liquid they need to choke down becomes difficult.

When my son was a preschooler, I realized that he swallowed some things whole ~ usually things he didn't like, like a piece of meat. He sometimes needed oral steroids for wheezing. Steroids in liquid form are notoriously nasty. He would vomit it back up most of the time. The tablets are really small, so I decided to have him try those once. Easy as pie for him! I don't think we even had to practice. I just told him to not chew because it would taste bad and he knew what to do. I think he was so young, he didn't know that he should be scared of choking.

If only most people could teach themselves like that... Despite it being difficult to learn, most people can learn to safely swallow pills. Once the technique is learned, the size and the shape of the pill is not usually an issue.

There are many tricks people use to swallow pills. What works for one doesn't work for another. If your child isn't willing to give it a try, it's really not worth it. Since this is a mind over matter thing, it will be impossible if they're not on board. If they're not ready, every once in awhile you can mention how big of a bite of food they just ate and comment that they swallowed it easily. Remind them to let you know when they want to try to swallow a small piece of candy. (For many the temptation of extra candy is an automatic selling point.) Don't wait until they have an illness to start because no one wants to learn anything new when sick. Once they get the technique, be sure to do it often enough that they don't forget until they need to use it.

Never practice with real medicine, even if it's over the counter stuff. Kids should know that they are practicing without real medicine. At the same time as teaching them to swallow pills you can talk about medication safety: only take it when an adult says it's okay, keep it away from other children, never share medicine with others, take it as the doctor prescribed if it is a prescription, and how and when to use over the counter medicines. It's a great skill for kids to know all of these things, and good to review until they have it all down. I am sometimes surprised at nearly college aged kids not knowing what common medicines are used for if they have aches and pains or illness. They need to know!

When I had to teach my daughter to swallow pills, I bought a container of Tic Tacs and told her that when she could swallow 3 in a row without choking, she could have the rest and eat them without permission unless she already brushed her teeth at night. She loved that idea and took to the challenge excitedly!

If you try one of these methods and it isn't working, you can try another. You can practice with both round and oval shaped candies since medicines come in both forms. Avoid having your child take huge gulps because that can cause them to lose control of the swallow. There are special cups that you put the pill in and then drink from them. I have no experience with them, so will not review them here. Commonly used methods to learn pill swallowing:

Starting small and working up

photo source: Shutterstock

For kids who are very hesitant, it is possible to start very small and work up to a standard pill size. Start with cake decorating beads, balls or sprinkles. Avoid the ones that are very lightweight because they might float and not go down as easily. Most kids agree that something very small will be easy to swallow. Have them show you they can. Build confidence by starting really small so they have a good first try. After they do it enough that they feel confident moving up (usually 3-5 successful swallows), use a bigger piece. Keep working your way up to a size that resembles most medicines. If a child fails a size, go back down to the smaller size to gain confidence. Don't spend more than 10-15 minutes each session. If the child tires or the stomach fills with too much water, it will be non-productive. Remember to praise any successes. Always end on a positive note by having the child swallow whatever size he can. So if it is unsuccessful to move to a larger size, have him go down a size, swallow successfully, then don't go up again at that session. You can always try again another day.

Straw Method

Different people like different positions for swallowing pills. Some do best with their head back, as is typical with drinking from a cup, so the pill has a straight shot down. Others do best with the head turned to one side or another. Some even change their preference over time. For those who prefer to have the head neutral or a bit forward, using a straw avoids having to tilt back to drink. Have your child put the candy on the front half of the tongue, then drink out of a straw with the straw at the front of the tongue so the liquid comes out in front of the pill. Tell them to focus on the drink, not the tablet. Some people say to put the tablet as far back as possible, but I think that can trigger the choking reaction, which is not helpful at all. Most of the time the pill will naturally go down with the liquid without even thinking about it. If you like to be green and don't want to fill a landfill with plastic straws, check out these fantastic glass straws. (I don't typically endorse products, but this is an entirely unpaid endorsement. We've had these straws for years. They go in the dishwasher daily. We've dropped them from table height. They still look brand new. We love them for many reasons, and since we use straws all the time, I don't feel guilty about our environment.)

Hidden pills

Some people feel more comfortable swallowing food than pills, so putting a pill in a soft food helps. Common foods are yogurt and applesauce. I've even heard of parents putting the pill at the top of a yogurt tube, and having the child suck down the yogurt. The biggest issue with this method is that if a child takes too long to take it, the tablet or capsule might start to break down, and then the child can notice the taste (which is often bitter). Another problem is if the child tries to chew the food first because most medicines meant to be swallowed should not be chewed.

Research proven techniques

For more help on learning to swallow pills, check out these videos that show how to swallow pills (link fixed 7.22.17) in different positions. Kids might like to see the techniques themselves before they practice.

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