Swallowing a pill is an important skill that many of us take for granted until
we have a child who needs to do it. Many things — from anxiety
to stubbornness — can make it harder for some kids to swallow pills.
Many medicines come in chewable or liquid form. But some are best taken as a pill
or tablet. In fact, some pills that are meant to be swallowed whole should never be
crushed or chewed. Doing so can be dangerous or prevent them from working as they
should. Some medicines work over a few hours instead of all at once. That won't happen
if the pill or tablet changes form.
As with any skill, learning to swallow a pill takes practice. Teach your child
at the right time and in the right way to make it a positive experience that builds
your child's confidence.
When Should Kids Learn?
The age at which kids can best learn to swallow a pill varies. Try to avoid comparing
your child with other kids, even siblings. In general, kids should be at least 4 years
old and at a stage when they seem cooperative and motivated to learn new skills.
Consider starting before your child needs to take medicine so there is no pressure.
Start with something very small, like an ice cream or cake sprinkle. After a few successful
tries, slowly increase the size of the candy (mini-chocolate chips or chocolate chips
may work). Then you can move on to a pill such as a non-chewable vitamin.
Practice when things like TVs and devices are turned off and there are no distractions.
Don't expect your child to learn this skill overnight. Practice for 5–10 minutes
a day for about 2 weeks.
What to Do
Before kids swallow their first real pill, remind them of other skills they have
mastered (like riding a tricycle or tying a shoelace). Explain why taking medicine
is important so they'll feel good about taking it. Then model the behavior. If possible,
let kids see you take one of your own medicine pills or a multivitamin before it's
When it's your child's turn to swallow a pill, stay calm and positive, even if
things don't go right the first time. Praise your child for trying. You also want
to avoid negative experiences related to pills. For example, if you sneak a pill into
your child's food and get caught, it may backfire and create mistrust.
To swallow a pill, kids should:
Sit up straight with their head centered and straight.
Tilt their head back only a bit. Leaning too far back can make it harder to swallow.
Take a few sips of water to "practice" swallowing.
Put the pill on their tongue and then drink the water again. (Sometimes having
kids drink through straws can help.)
If the pill doesn't have to be taken on an empty stomach, your child can take sips
with something thicker than water, like milk or a milkshake. You also can try putting
the pill in a semi-solid food like pudding, ice cream, or applesauce.
Praise your child if they swallow the pill successfully. If not, try again. If
your child refuses, stop and take a break. You can try again later.
If the pill seems too big for your child to swallow, ask the pharmacist
if it's safe to cut it into smaller pieces.
When Should I Call the Doctor?
With patience and practice, most kids will learn the skill of swallowing a pill.
Some kids, though, might have trouble with it, including:
Kids who are very anxious about new medicines or new experiences.
Kids who had a bad experience earlier (like gagging or vomiting) when they tried
to swallow a pill.
Kids with developmental delays; oral-motor problems (such as speech problems or
refusal to eat certain food textures); or behavioral problems (which could include
refusing to take any medicine)
For these kids, it may be wise to delay training and to speak to a doctor first. There
might be other ways to take the medicine, such as in liquid form or as a tablet that
can be chewed or dissolved.
When you give your child any medicine, follow the directions on the label and talk
to your doctor or pharmacist if you have questions.