By Dr. Matthew Wylie
Department of Pediatrics

Swallowing pills is easier for some than others. It may be particularly challenging for young children. The “tween” age, 10-12, is a good time to start swallowing pills. Kids are often getting to a size where adult dosing is appropriate and many quickly find they prefer pills or capsules to large liquid doses. However, there are many child medicines that only come as pills, or sometimes insurance will not cover more expensive liquid or chewable formulations, so it becomes necessary for younger kids to swallow pills.

Once a child matures to the point where they can understand instructions parents can begin the process of teaching their children how to swallow a pill (this can be as young as four years old). Some kids master the skill quickly, but for others it takes some practice and parental creativity.

Begin with water

A good place to start is helping your child to swallow multiple gulps of water. Have your child sit upright and bring a cup of water up to their mouth; do not allow them to bring their mouths to the cup. Encourage your child to take a gulp of water and swallow it all of it at once, so a continuous stream of water goes down their throat. Have your child gulp and swallow three times in a row. Keep practicing until your child gets the hang of it. Some children will hold the water in their mouths and swallow it gradually, or swish it around in their mouths before swallowing, so practicing the gulp and swallow technique will be needed.

Small candies can simulate pills

Once your child has the hang of swallowing gulps of water, they are ready to try practicing swallowing simulated pills. Small candies, such as M&Ms or Tic Tacs could work (you could start with mini M&Ms or sprinkles and work your way up). You can also cut up fruit into very small pieces. Ensuring that your child has their head upright, help them to place the piece in the middle/back of their tongues. Then repeat the process of taking three quick continuous gulps of water, which ideally washes the candy down their throats. Even if the candy goes down on the first swallow, do two more swallows for good measure. Be sure to check that the candy went down with the swallows.

Be patient – it can take time

It is likely that more than one pill-swallowing training session will be needed. Keep each session to no more that 5-10 minutes. If your child gets frustrated with the process, it may delay their willingness to swallow pills. Try making the training fun, maybe using a favorite beverage or candy during the training sessions. You can also try practicing with Jell-O during the swallowing training, eventually slipping the simulated pill into a spoonful of their favorite flavor. And don’t skimp on the praise! When your child succeeds or demonstrates great effort, heap on the applause and hugs!

Despite your and your child’s best efforts, it could be that your child isn’t yet ready to swallow pills. If this is the case, talk to your healthcare provider or pharmacist about crushing or cutting up pills or getting the medication in liquid form, if possible.

Swallowing pills is just one milestone for growing children. Like so many other skills, practice makes perfect!