Teaching Your Child How to Swallow Pills

Swallowing a pill is an important skill that many of us take for granted until we have a child who needs to swallow a pill. Many things — from anxiety to stubbornness — can make it harder for some kids to swallow pills.

But don't worry. Just like any skill, learning to swallow a pill takes practice. If you teach your child at the right time and in the right way, it can be a positive experience that builds your child's confidence. In no time, it'll be something that you both take for granted.

Why Pills?

While a lot of medicines come in chewable or liquid form, some medicine is best taken as a pill or tablet. In fact, certain pills that are meant to be swallowed whole should never be crushed or chewed, as this can be dangerous. And some medicines are meant to work over a few hours instead of all at once. That may be impossible to do if the medicine is a chewable or a liquid.

Before giving your child any medicine, follow the directions on the medicine label and talk to your doctor or pharmacist if you have any questions.

When Should Kids Learn?

Every child is unique, so the age at which kids learn to swallow a pill will vary. 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.

Ideally, you'll want to practice 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 attempts, gradually 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 cellphones are turned off and there are no other distractions. Don't expect your child to learn this skill overnight: practice for 5 to 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), and explain why taking medicine is important in the first place so they'll feel good about taking it. Then model the behavior. If possible, let your child see you take one of your own medicine pills or a multivitamin before it's his or her turn.

When it's your child's turn to swallow a pill, remember to stay calm. If you're nervous, your child will be, too. Stay positive, even if things don't go right the first time, and avoid any negative feedback. You also want to avoid negative experiences related to pills. For example, trying to sneak a pill into food and getting caught may actually backfire by creating mistrust.

To swallow the pill, have your child:

• sit up straight with the head centered and straight
• avoid tilting the head too far back, which can make swallowing more difficult
• have your child take a few sips of water to "practice" swallowing
• then, put the pill on your child's tongue and then have him or her drink the water again. (Sometimes having kids drink through straws can help distract them by focusing on something different.)

Check the directions to see if a pill can be taken with food. If the pill does not have to be taken on an empty stomach, you can have your child 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 or applesauce.

Praise your child if he or she swallows the pill successfully. If not, calmly tell your child that it's OK and try again. If your child refuses, stop and take a break. You can always try again later.

If the pill seems too large for your child to swallow, ask the pharmacist if it's safe to cut the pill into smaller portions.

When to Seek a Doctor's Advice

Chances are that with enough 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 prior experience (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.