How to Make Swallowing Pills Easier for Children

Swallowing pills is a skill most kids learn around 10 years of age. Before that, a fear of choking or simply worrying pills are too big keeps many kids from trying. Some kids aren't swallowing pills even when they are teens, which presents challenges for treating common health conditions.

While some medications can easily be crushed and hidden in food and drinks, this isn't possible for all medicines, such as those with extended-release delivery systems that need to be swallowed in order to ensure safety and effectiveness.

Helping Your Child Take a Pill

Many kids with chronic medical conditions who take medicines daily learn to swallow pills earlier than others—sometimes as early as age 6. Other kids may only be faced with taking pills on rare occasions.

Some may need practice, while others can seem like automatic pros. The following tips can help your child get the hang of swallowing a pill.

Practice

A few (or more) trial runs can help kids get used to the sensation of swallowing a pill without running the risk of missing a dose of medication if things don't go as intended. This usually works for kids who are simply afraid of trying to swallow a larger pill because they think they might choke, and it's wise to try before a child actually gets prescribed a medication in pill form.

• Have her start by trying to swallow something other than a pill. For example, choose candies in four or five different sizes. She can attempt to swallow something as small as a sprinkle and then work her way up to a Tic Tac or a small piece cut from a gummy worm.
• Tell her to place the candy in the center of her tongue and then try to drink a whole glass of water through a straw. (The child can concentrate on the straw and not think about the pill going down.)

The Real Thing

It's important, of course, that a real medication dose be taken completely and as directed. A few special strategies can help things go according to plan.

Have your child:

• Drink a little water before putting the pill in their mouth.
• Put the pill on the back of the tongue, take a drink of water, and then tilt the chin down toward the chest before swallowing. Alternative: Put the pill on the front of the tongue and tilt the head back before swallowing.
• Try the "big gulp" method: Put the pill on the child's tongue and then tell them to fill their mouth with a lot of water, swish the water all around for 15 seconds, and then swallow.
• Gargle for 30 seconds or take a deep breath (through the nose) before trying to swallow the pill.
• Chew some food, like a cracker or piece of bread, and then place the capsule on his tongue just as he is about to swallow the food

Continued Trouble

If your child has tried to swallow a pill and can't, then further attempts using these strategies alone likely won't work.

For many kids, it often seems like the pill is just staying in place. It could be that they are holding it there, against the roof of the mouth, with their tongue as they try to swallow. The trick might be simply for them to learn how to relax their tongue a little as they swallow the pill (or at least get distracted enough so that the pill goes down).

You can mix a whole pill or capsule into a soft food, like applesauce or yogurt; the viscosity of the food may help disguise the pill. Before you consider crushing a pill into food or drink (which is sometimes done with ADHD medicines and even Tamiflu capsules), consult with a pharmacist to make sure that is safe and otherwise advisable.

Pill Glide, a non-prescription flavored spray, may also be helpful. Or try a pill cup, which has a small basket that holds the pill in place while your child takes a drink, then releases it into the mouth.

Asking for an Alternative

In some cases, medications may be available in other forms. While choosing one is probably the simplest alternative to swallowing pills, there will likely be times when your child has no choice but to take a medication in pill form, so it's best for them to learn how.

Still, you may want to ask your healthcare provider about liquid medications (older children may need several teaspoons, however), chewable and dissolvable tablets, granules, and disintegrating tablets. Some examples include:

• Allegra ODT (fexofenadine) Oral Disintegrating Tablets
• Amoxicillin (Amoxil) 250 mg Chewable Tablets
• Amoxicillin-clavulanate (Augmentin) 400 mg Chew Tabs
• Clarinex (desloratadine) RediTabs and Claritin (loratadine) RediTabs
• Methylin (Ritalin) Chewable Tablets
• Orapred ODT (prednisolone) Oral Disintegrating Tablets
• Prevacid SoluTab (lansoprazole)
• Singulair Granules and Chew Tablets (montelukast)
• Zyrtec (cetirizine) Chewable Tablets