Children who have trouble swallowing pills can be taught to do so as young as two years of age, according to a new review study. The research, published in the online journal Pediatrics, identified five simple techniques that have been used successfully to teach children how to swallow pills.
For the study, researchers from the University of North Carolina (UNC) School of Medicine analyzed studies on pill-swallowing techniques published between December 1986 and December 2013. The researchers included studies that involved more than 10 participants ages 21 years and younger, and excluded those with children who had medical conditions that affected swallowing.
The research team found five studies with successful techniques for helping children swallow pills. The most successful – all 33 children in the study learned to swallow pills – involved teaching the kids five different head positions while taking their pills, including keeping their chin-up or turned to a side.
Other proven techniques included using behavioral therapy such as starting with a small pill and moving to a larger pill; applying flavored spray to the throat first to help the pills slide down; using specialized pill cups, and giving children scripted verbal instructions. A six-month follow-up found that the children who learned to swallow pills using these techniques were still able to successfully down their medicine.
The researchers also discovered that children as young as 2 years of age could be taught to swallow pills. The authors noted that one study found that children ages 4 to 5 needed fewer training sessions than older children.
About one in three children have difficulty swallowing pills of any size, and according to an American Academy of Pediatrics (AAP) news release, more than 50 percent of kids have trouble swallowing a standard-size pill or capsule. There are a variety of reasons a child may have problems swallowing pills, including anxiety, pill size, texture and taste, or difficulty with the physical technique required to swallow a pill.
One expert advised that children should practice pill swallowing, especially when they are not sick.
“I recommend practice, lots of water and start small,” Jaime Friedman, MD, a pediatrician at Children’s Primary Care Medical Group in San Diego, told HealthDay. “My partner taught his son using Tic-Tacs.”
Although there are other options to pills and capsules, they are not always appropriate. Crushing pills into food is not generally advised, especially when extended-release medications are prescribed. And while liquids would seem the ideal solution, they are not always available to treat a specific illness.
“For some medications like most ADHD meds, there isn’t a choice, so the kids have to learn,” said Friedman, who was not involved in the study.
The authors acknowledged their review was limited by the small number of studies that met their criteria, and called for larger, more rigorous studies into swallowing methods. “Unfortunately, studies that evaluate the effectiveness of pill swallowing interventions are limited by their small sample sizes, observational study design and lack of controls,” the authors wrote.
“At this time, research is the most efficient way to prospectively identify children with pill-swallowing difficulties and implementing targeted interventions before it is medically necessary for them to swallow pills should be a priority,” urged the study team.
