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Home / News and Events / General News / Children Can Learn to Swallow Pills
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Children Can Learn to Swallow Pills
April 22, 2015

Mary Poppins recommended a spoon full of sugar. Doctors are finding more effective ways to help the medicine go down.

Children who have trouble swallowing pills aren't out of luck, according to a new study published by the journal Pediatrics. Researchers found five strategies that may help children swallow pills and capsules more easily.

Five ways to help children swallow pills

  • Using flavored pill swallowing throat sprays, available at most pharmacies
  • Giving children verbal instructions
  • Behavioral therapies
  • Using a specialized pill cup
  • Training children to use different head postures

"Pill swallowing difficulty is not an uncommon problem," said study co-author Dr. Kathleen Bradford, a pediatrician at North Carolina Children's Hospital. The key is practice, especially when children are not sick, so they don't need to learn on the fly."

"I recommend practice, lots of water and start small," said Dr. Jaime Friedman, a pediatrician at Children's Primary Care Medical Group in San Diego. "My partner taught his son using Tic Tacs."

Starting "pill swallowing training" earlier rather than waiting until your child has had bad experiences, Bradford's team reported. Researchers found that children who practiced swallowing with their head turned or their chin tilted up or down discovered a head position that helped them swallow pills. 

Study co-author Dr. Ravi Jhaveri said there are many reasons children have problems with pill swallowing. "Some are behavioral, including anxiety, and others include problems with pill size, texture and taste, as well as the physical technique required to swallow a pill," he said.

Doctors can prescribe a liquid, but liquid is not always an option, said Friedman, who was not involved in the study. Over-the-counter sprays, marketed as pill swallowing aids, were shown to help child swallow pills. 

"For some medications, like most ADHD meds, there isn't a choice, so the kids have to learn," Friedman said. "I think children have trouble because it is a new sensation and they are afraid of gagging or choking or vomiting. The paper was not specific about what the behavioral interventions were, but I think relaxation is key."

Most of the studies reviewed in this paper involved small numbers of children, but they showed high levels of success with the various methods.

For example, one study teaching behavioral interventions enabled 17 of 29 children to take large capsules for at least six months. Another study with behavioral interventions had success with all but one of 23 children.

In another study involving 67 children who initially could not swallow pills, 47 learned to do so by following scripted instructions, and nine others learned with the script once they had a small pill cup.

The study with the flavored throat spray had just 11 children, seven of whom could swallow a small candy after using the throat spray.

Finally, all 33 children who were taught five different head positions and completed a two-week practice plan were able to swallow pills successfully after those two weeks.

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