How to teach a child to swallow pills?

Question

All my kids are bad at swallowing pills. For whatever reason, it doesn't go to the back of the mouth easily for straightforward swallowing.

This is particularly problematic for the oldest (now 10), who has bad seasonal allergies and needs to take anti-histamines occasionally -- and it takes a long time, lots of water, and angry tears (from her, not us) before it either is swallowed accidentally, or dissolves enough in saliva/water to go down that way.

Being able to swallow medication would let her avoid the bitter taste, get her relief more quickly, and generally make everyone more relaxed. What are some strategies to help kids learn how to swallow pills efficiently? We have tried showing her what works for us and it just isn't getting across, somehow.

Answer 1

Try a two-pronged approach:

1. Teach proper technique. Many of us were taught to tilt the face upward when swallowing, but recent research see here shows, that this actually makes it harder to swallow. The suggestion is to either
   a) put the pill on the tongue, then suck a big gulp of water from a plastic bottle or
   b) put the pill on the tongue, take some water into the mouth, then tilt the head down when swallowing.
   The link above also gives detailed instructions with pictures.

2. Let them practice. A small peace of candy (mimicking size and shape of the pills, e.g a TicTac, better not too sticky) could be the dummy for test runs. Doesn't leave a bad taste when the first attempts don't work. So when necessary, the kids know what to do. Just remember to remind them (again, I suppose) that real medicine is not candy and while the candy may take the place of a pill for this exercise, it's never, never the other way round.

Answer 2

There's technique as @Stephie detailed (+1 btw), but don't forget the psychology. No one wants to swallow a pill, especially young ones (rather ironic since they don't always want to chew their food well, either). For my daughter, we made it a game: Get the boat to float in the water and then swallow it all. Years later she still referred to "floating the boat" when taking meds.

Find a way that works for each child's psychology and you'll be able to get past the mental blocks as well as the technical.

Answer 3

Here are a few things I've recommended. I know this might gross some people out.

Some pills (some antibiotics and others) are notoriously bitter/ bad tasting. As soon as they hit the tongue, they start to dissolve, leaving a bad taste and a desire to spit the thing out, which only makes you hold it there longer and get more bad taste in the mouth. A butter or olive oil coating (butter works better in my experience) prevents the pill from starting to dissolve in the mouth before swallowing. Have the child place the lubricated pill as far back on the tongue as possible (fewer taste buds, and closer to the finish line), then take a sip of cold water or juice. The cold keeps the lubrication on the pill, and there's less taste of medicine. It has no effect on absorption in the stomach.

Pills 'stick' to a dryish tongue. Avoid this by (either butter or) having your child take a decent sip of water/juice and tilting her head back, open her mouth (she should be able to do this at ten) and drop the pill onto/into the pool of liquid. Close mouth and swallow. If the pill is a floater, tilt your head forward a bit to swallow. If it's a sinker, head back of neutral. Some kids find turning their head to the side 45° helps. I don't know if this is a plecebo effect or not. In either case, it gives the child something to think about besides the pill.

Try putting the pill in cold yoghurt. It goes down quickly and adds a barrier to sticking on the tongue.

I have never done the graduated size training, but if you don't mind your child practicing on candy, this is a nice reference: pill swallowing made easy.

Answer 4

As a kid, I learned by putting the pill in a dab of yogurt on a teaspoon. It was the old-fashion thick yogurt with lots of sugar. Unlike a pill (or even a piece of small candy) swallowing a blob of yogurt feels natural. The yogurt acted as a lubricant against the pill sticking to a dry mouth or tongue. The yogurt also overpowers the bitter taste you might get from the pill.

Answer 5

I always hated taking pills. Here are some things that helped me:

Practice swallowing with soft and slimy food objects first. I recommend standard (cooked) cheesy noodles made with elbow or shell macaroni. Pick one noodle out with your spoon and see if you can swallow it without chewing. (Disclaimer: Supervise in case of choking. I never had problems with this, but kids have different abilities and younger kids may need more help.)

For pills that can be taken with food, take a bite of some soft food like noodles, soft bread, or cake and chew thoroughly. Just before swallowing, open your mouth and use your clean finger to press the pill into the mass of food. Then swallow. Counter-intuitively, having a larger mass to swallow is actually easier than a small pill. (Also, a bite of cake can be a small bribe to make the experience more pleasant.)

Answer 6

The technique that worked for me was to gently hold the pill between my back teeth, take a big gulp of water and let release the pill as I swallow the water. That way, the pill isn't sitting on your tongue tasting nasty and sticking to it.

I've never tried to teach a child to swallow pills but I did use that technique to teach a ~20-year-old adult who'd never managed to swallow pills before.

Answer 7

While some pills you can't really do much about, many medicines (such as pain relievers, antihistamines, etc.) come in several different forms, and some are easier to swallow than others.

In the same vein as the 'training' idea, if he has to take a Claritin every day, get the kind that have a coating that tastes good or even the ones that dissolve in the mouth; having to take a difficult, bad tasting pill every day won't necessarily improve things when the antibiotics come around - you'll just have bad memories and dislike it even more. Then migrate to slightly harder pills over time.

Answer 8

I used to have the worst problems both with taste and with it sticking to my tongue, and this technique solved both issues for me. I'm the only one I know who does this, and I'm not sure how I came up with it, but maybe it will help.

I actually put pills under my tongue, just behind my bottom front teeth. Then as the water comes in, I use the tip of my tongue to lift it into the stream. Probably some dissolving happens, but because it's not on the taste-sensitive part of my mouth, it doesn't bother me. It also isn't on my tongue long enough to get stuck there.

I think it works for me because the tip of the tongue is so much more agile than the back. It's worth a try, at least.

There are also special pill swallowing cups with a little shelf that makes the pill move with the water before it enters your mouth.

Answer 9

I was terrible at swallowing pills for years. My inability to swallow tablets and capsules was a contributing factor to simply lying down in bed when I had a headache instead of taking some Tylenol, for example. The few times where I had an acute condition that required swallowing a pill, it would be a big chore that occasionally resulting in spitting out the pill entirely before starting over again.

When I was in college, I was diagnosed with a chronic condition with no cure. There's treatment which prevents the symptoms, but I will most likely live with the disorder for the remainder of my life. Naturally, as something relevant to this question, the treatment involves taking pills.

My parents never tried to get me over my inability to take pills in my youth. However, terminating my medication today is potentially fatal (and even if I didn't die, I'd lose my driver's license which pretty much makes life suck in the majority of the US). I learned REAL fast how to take my pills when the consequences for not taking them were worse than the PITA of taking them. After taking pills twice a day every day for years, I can practically swallow them without any drink assisting me.

I'm not saying you need your kids to be diagnosed with a life-threatening disorder in order to get them to take their pills; many adults swallow pills without ever being diagnosed with anything more serious than the flu. My point is that, if taking the pill is less cumbersome than the alternative, you've got the motivation to learn. Then, if you have practice, you become really good at it.

Does your daughter understand how bad her allergies are? You've said the pills take a long time, a lot of water, and angry tears to get the process over with... but what would happen if the pills were skipped entirely? Depending on exactly what the allergy is (you say "bad"), I can certainly visualize much worse without the antihistamine.

If you can, I would try finding a medication that is fast-acting, and permitting your daughter postpone taking the pill until she can't stand not taking it. With a fast-acting medication, this would let her get relief soon after "admitting defeat," so to speak, and giving your daughter the choice of when to take the meds would give her additional control over her life.

Of course, it's possible that she'll avoid taking the medication at all, resorting instead to things like hydrating and Kleenex. I did the same thing when I was younger, and often toughed out in order to avoid taking pills.

If she avoids taking the pills and then complains about the allergy symptoms, remind her that she can make them go away by taking her medication.

Note: This option may be difficult to implement if she needs to take the medication while at school, as many schools do not permit children to carry around drugs of any kind, forcing them to store them all at the nurse's office.

Additionally, if your daughter's allergies are bad enough that avoiding the medication is a serious threat to her health, do NOT do this. While I personally got over my own issues with taking pills while in the face of something life-threatening, I was also well into my adult years by that point, and truly able to comprehend the consequences of my actions (or inaction). If her allergies pose a health risk, make her suck it up and take those pills (suggestions from other answers may help there); I'm sure you'd rather have a crying daughter than, for example, an emergency room visit.

Answer 10

Try practicing on Tic-Tacs or small tablets - i.e. vitamins. Also, a nurse advised us when swallowing a pill to put your head down and to the right. This has been very helpful; and will certainly - if nothing else - help in preventing painful swallows!

I hope this helps! :)

Answer 11

I've always be horrible with taking pills, even now I can only really manage a small, round-shaped Tylenol, but a couple of things that help me (which goes against some of the advice mentioned here, I'll admit):

• Use a wide-rimmed glass with a small amount of water. A short glass (like a juice glass or smaller) helps me a lot.
• Before taking the pill, I keep my mouth shut and don't swallow until I'm almost at the point where I need to.
• Fire drill time: I quickly place the pill on roughly the middle of my tongue – more like the front third of the back of it – then take a quick, forceful drink of the water. I take no more than a couple seconds to do all of this.
• I don't tilt my head in any direction any more than just enough to get a drink of water from the glass.

Answer 12

First take some water in your mouth then raise ur head up and open ur mouth. Now drop the pill in the water and gulp the water and pill together. This technique will eradicate tasting the wierd taste of the pill while eating it and easier to swallow pillows that are little extra sized.

Answer 13

I had quite a time learning how to swallow pills. What finally succeeded was practicing on slippery stuff--IIRC chunks of orange but it was so long ago I won't swear to the exact food. Once I mastered the swallowing of the slippery stuff I could handle the ordinary ones.

Answer 14

I have found the best way is to just dissolve the pill in a cup of juice first. Not too much liquid, so its not a chore to finish it. Works every time, and the child doesn't associate medicine with a bad experience.