When Your Child or Teenager Can't Swallow Pills

Swallowing pills is a skill that most kids learn around 10 years of age, but some still aren't able to even as teenagers. A fear of choking or simply worrying that pills are too big to swallow keeps many from trying. This presents challenges for treating common health conditions.

While some medications can easily be crushed and mixed into food and drinks, that's not possible in all cases. For example, some ADHD medications are extended-release formulas that need to be swallowed whole to ensure their safety and effectiveness.

This article offers tips on helping your child or teenager learn to swallow pills, including what to do if they are unable to take their medication as prescribed.

Practice "Pills"

A few (or more) trial runs can help kids and teens get used to the sensation of swallowing a pill without running the risk of missing a dose of medication if things do not go as intended.

This method usually works for those who are afraid of trying to swallow a big pill because they think they might choke on it.

This tip is best to try before they actually get prescribed a medication in pill form.

Here's what to do:

• Have your child start by trying to swallow something other than a pill—for example, candies in four or five different sizes. Have them attempt to swallow something as small as a sprinkle and then work up to a small mint.
• Have your child place a candy on the center of their tongue. Then, have them try to drink a whole glass of water through a straw. Have your child concentrate on the straw and try not think about the pill as it washes down their throat.

Trying Real Pills

Your child's real medication dose must be taken completely and as directed. Here are a few special strategies that can help your child take their pills the way they need to.

To start, have your child:

• Drink a little water before putting the pill in their mouth
• Put the pill on the back of the tongue, take a drink of water, and then tilt their chin down toward their chest before swallowing. You can also try having them put the pill on the front of their tongue and tilt their head back before swallowing.
• Try the "big gulp" method: Put the pill on your child's tongue and tell them to fill their mouth with a lot of water, swish it around for 15 seconds, and then swallow.
• Gargle for 30 seconds or take a deep breath through their nose before trying to swallow a pill
• Chew some food, like a cracker or piece of bread, and then place the capsule on their tongue just as they are about to swallow the food

If They Are Still Having Trouble

For many kids who are struggling to swallow pills, it can seem like the pill is just staying in place. In this case, they might be holding it against the roof of the mouth with their tongue as they try to swallow.

To fix this problem, the trick might be for them to learn how to relax their tongue a little as they swallow the pill—or at least get distracted enough so that the pill goes down.

Here are some other solutions that may help.

Crushing Tablets or Opening Capsules

You might be able to disguise a pill or capsule by putting it into a soft food like applesauce or yogurt, or mixing it with water. For example, some antibiotics and even Tamiflu can be taken with these tricks.

However, always ask your prescribing provider or pharmacist before crushing a pill and putting it into food or drink. Some medications will not work or could be unsafe if you take them this way.

Pill Swallowing Aids

If your child needs to take a whole pill, there are some tools you might want to try:

• Pill Glide: A non-prescription flavored spray that coats your child's mouth and throat to make swallowing a pill less uncomfortable
• Pill cups like Oralflo: These have a small basket that holds the pill in place while your child takes a drink, then releases it into the mouth. (These aids are not for use in children younger than age 4.)
  

Ask About Pill Alternatives

Your child's medications may come in other forms. You may want to ask your healthcare provider about liquid medications, chewable and dissolvable tablets, granules, and disintegrating tablets.

Possible alternatives to pills for common medications for kids include:

• Allegra ODT (fexofenadine) Oral Disintegrating Tablets
• Amoxicillin (Amoxil) 250 mg Chewable Tablets
• Amoxicillin-clavulanate (Augmentin) 400 mg Chew Tabs
• Clarinex (desloratadine) RediTabs and Claritin (loratadine) RediTabs
• Methylin (Ritalin) Chewable Tablets
• Orapred ODT (prednisolone) Oral Disintegrating Tablets
• Prevacid SoluTab (lansoprazole)
• Singulair Granules and Chew Tablets (montelukast)
• Zyrtec (cetirizine) Chewable Tablets

Choosing a different form is often the simplest alternative to swallowing pills, but there will likely be times when your child has no choice but to take a medication in pill form, so it's still beneficial for them to learn how.

Summary

Swallowing pills can be challenging for people of all ages, but kids tend to have a harder time getting the hang of it. There are some things you can do to help your child learn to swallow pills, as well as make pill-taking safer for them.

If your child is not able to swallow pills even with these strategies, ask their provider if there are any alternative ways for them to take their medication.