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Help! My child can’t swallow pills (but needs to)

December 02, 2014

It seems like a no-brainer; just pop the pill in your mouth and swallow. It’s easy to forget, though, that swallowing a pill is something that has to be learned. It may feel normal and natural to us grown-ups, but it’s not normal or natural for kids. For children that need to take medications, either for an unexpected illness or a long-term problem, this seemingly small issue can produce a lot of anxiety, making it a really big issue. If you’ve ever sat on your kitchen floor with a screaming kid saying, “I cant, I can’t. I can’t do it!” you know what I mean.

The good news is, there is hope. You can teach your child how to swallow pills, and there are a few tricks that can help you do it. A good rule of thumb is that by the time your child reaches 10 years old, they should be fairly comfortable swallowing pills. If your child has a chronic illness that necessitates frequent medications, you may find that you’re better off teaching them sooner rather than later.

In my years as a retail pharmacist, I occasionally encountered adolescents and even some adults who had developed a severe aversion to swallowing pills. Their anxiety had become so great that it required a lot of time and effort (mostly for them) to avoid this problem. This is the worst-case scenario, and it can be avoided.

Getting a child to swallow a pill is sort of like potty-training. You can teach them what they should do, but you can’t make them do it. You have to let them exert their own control over the process and get there when they get there. Heavy-handed pressure often backfires. You can’t force a kid to poop on the potty, and you can’t force them to swallow a pill.

Here’s what you can do:

Boy Drinking from Water GlassPractice gulping down a liquid. Give them their favorite drink (you know, the kind with lots of sugar that they’re never allowed to have) and encourage them to guzzle it down with big gulps. Make it fun, like a contest. Or have them pretend that they’ve been stranded in the dessert, and this is the first drink they’ve had in days. Have them tilt their head back and lift their chin to the sky and gulp it down.

Practice with candy. Once they’ve mastered the big gulp have them use this same technique, but this time with candy. Start with one Nerd- it’s tiny and just about anyone can swallow it. Place the Nerd on the back of their tongue and have them swallow it with a gulp of water (or a favorite drink). Then move on to the mini M&Ms with the same process. You don’t have to do all of these things in the same day. A little practice repeated over time makes steady progress. After they’ve mastered the mini M&M, try the regular sized M&Ms. Once they can confidently swallow an M&M, they’re ready to try a tablet or capsule.

 Help them relax. Children respond to the pressure we place on them. If they feel like this is a make-or-break situation, they might become fearful that they won’t be able to produce the results you are demanding. Instead, relax. Smile. Be playful. If you’re relaxed about it, they will be better able to relax, too.

 Reward, reward, reward. Encourage them with a reward for their effort. Be sure you aren’t offering a reward for the desired outcome, but instead a reward for their bravery in trying. For some kids, this may be a sticker chart or extra TV time or one-on-one time with Mom and Dad. You know what motivates your kid, so let them know that there are rewards for putting in the effort. Once you’ve communicated what there is to gain in this endeavor, back off and let them choose when they get there.

 Ignore the negative behaviors. Reward the positive behavior and ignore the negative ones. You might be tempted to exercise discipline to stop the whining and crying and complaining, but in the end it isn’t likely to be helpful. The more fun and exciting and adventurous you can make this process, the less anxiety and fear your child will have about it.

You know the old saying, “You can lead a horse to water, but you can’t make him drink”? Well, you can give a kid a pill, but you can’t make him swallow. The trick is making him want to.

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