Swallowing pills is one of those skills that come naturally for some kids, and for others it takes practice. In fact, about 26% of kids have a hard time swallowing them. Some are worried it will get stuck in their throats and others have never tried it before and therefore need a bit of guidance.
Taking pills instead of liquid medication has its benefits: They are easier to take with you, they leave little to no taste in their mouths, and sometimes it gives doctors more prescribing options.
If your kids are having a hard time swallowing pills, they’re not alone! The good news is that there are tried-and-true behavioral strategies that can help them learn. As a pediatric psychologist, here are some of the tips we use to teach our patients:
TIPS FOR TEACHING KIDS HOW TO SWALLOW PILLS
1. Gather your supplies
You’ll need small paper cups to make sure that they’re not swallowing too much liquid, candy of increasing sizes, and empty pill gel capsules. Check with your pharmacist to see if they have any in stock.
2. Practice when they’re healthy
The best time to practice pill swallowing is when they’re not under any pressure to take medicine.
3. Keep the sessions short and fun
Practice every day using the following steps until they’re comfortable swallowing pills. I recommend limiting each session to about 5-10 minutes so that they don’t feel overwhelmed. And try to make it fun! Use different candies of increasing sizes, such as cupcake sprinkles, Nerds®, Tic Tacs®, mini M&M’s®, regular M&M’s®, Good & Plenty®.
4. Use imagery and positivity
Have your kids picture their throat like it’s a water slide, and the pill is the inner tube gliding down the hill. It is also helpful to provide positive reinforcement along the way. Older kids will benefit from having them say things like “I can do this,” “I will be okay,” and “My body can handle this.”
5. Give them lots of options
Giving them options will make them feel like they have a sense of control. “Would you like to sit or stand?” “What would you like it mixed with?” “White cup or pink cup?”
6. Start with water
Have your kids start with a sip of water (without a piece of candy) to practice. Make sure that they’re not swishing the water in their mouths.
7. Then dissolve it
Starting with the smallest candy, have them place it toward the back of their tongues and let it dissolve back there.
8. Increase sizes gradually
Once they’ve mastered dissolving the smallest size in the back of their tongues, it’s time to attempt to swallow it. Have them place the smallest candy on the back of the tongues (while keeping it flat) and then take a sip of water to swallow the candy. Repeat this 2-3 times so that they feel successful moving on to bigger sizes. It may take multiple drinks and tries to get the candy to go down, so keep the encouragement going. They may find it helpful to try different head positions. Turning the head to the side relaxes the throat which can make it easier for pills to slide down.
Continue increasing the size of the candy until your kids can swallow the size of candy that is equal to the size of their pills. If they reach a size they cannot swallow, return to the last size they successfully swallowed so that they can end the session with success. Then return to the process the next day. Once they’re comfortable swallowing candy, they’re ready to try empty capsules or actual pills.
10. Make it easier
Even when kids are capable of swallowing the largest size candy, they may still need some extra help and strategies. Here are a few to help make swallowing easier:
- Put the pill in a spoonful of Jell-O or pudding, which will help it slide down your child’s throat. Have them practice swallowing just the Jell-O before trying it with the pills. Do not hide the pill in the Jell-O because this can break trust between you and your child.
- Try coating the pill with magic shell.
- Dip the gel gap in ice water before swallowing to make it very slippery, or use pill glide swallowing spray.
- Use a special pill swallowing cup, such as Oralflo.
- Crush the pills in flavored syrup, if these strategies aren’t working. Check with your pharmacist first to make sure the pill can be crushed.