How to Help Kids Swallow Pills

Does your child have trouble swallowing pills? Up to 50 percent of kids can’t gulp down a standard-size capsule, the American Academy of Pediatrics notes, for reasons including texture, taste or size.

Luckily, though, there’s help. Flavored throat sprays are among successful tactics, the AAP said in a recent review of 27 years of pill-swallowing intervention studies.

For more tips, we asked Dr. PaoLin Chi, a pediatrician at St. Joseph Mercy Ann Arbor and IHA Child Health Ann Arbor.

What’s going on

Kids have a harder time than adults because they aren’t as familiar with their bodies, Chi says. “It’s truly a mind over matter thing.” Chewed food is soft. So swallowing something hard can prove scary, activate the gag reflex and make kids anxious.

Candy test run

Practicing with small candies can make the experience less scary.

“I recommend starting with a tiny – a mini – M&M. It’s round in shape like medicine but doesn’t have the bitter taste and doesn’t look as scary,” Chi says. If the child masters that, try a small Tic Tac. Then ramp up to a full-size M&M.

“If they can swallow an M&M, they can swallow anything.” You can also start with cake sprinkles or Nerds. Or chop gummy worms, which are softer, into tiny chunks.

Limit this to one to two times a day, Chi says. Try daily until the child’s ready for the real deal. “(Start) when the child is well and healthy, not when they are sick and must take the medicine,” she says – and swallow with water or juice, like they would with a pill.

Tickle taste buds

In many cases, “If you don’t swallow (pills) right away, they become bitter, and that can be very off putting to children,” Chi says. She finds many parents hide small pills in spoonfuls of ice cream. The child doesn’t have to see the pill, bitterness is masked by the sweet taste, and it’s an overall more positive experience. Try peanut butter or applesauce, too.

Whether you let your child know that a pill is hidden in his food is up to you, Chi says. “I usually encourage open communication.”

Don’t crush

“There are certain tablets you really can’t crush up.” She recommends always talking to a pharmacist first. Some medicines must be absorbed in specific ways, and crushing certain pills can lessen the accuracy of the medication.

Draw a picture

“Sometimes showing the child the size of the esophagus compared to the pill can help,” Chi says. Drawing a circle 1.5-2 centimeters in diameter – the average width of a small child’s esophagus – can lessen the child’s fear if he can see how small the pill is in comparison.

Take a chill pill

“Patience is the key,” Chi says. If a child is struggling, “Don’t push. Keep going with what they can conquer,” she says.

Illustration by Mino Watanabe


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