Study suggests techniques to help kids swallow their pills

Missed doses can make children sicker, but a flavoured spray or a special cup could help them get the hang of it

Many sick kids can’t or won’t swallow pills — and that can make them sicker. But there may be some pretty simple ways to help the medicine go down, a new study says.

Dr. Kathleen Bradford and colleagues at the University of North Carolina in Chapel Hill reviewed research on pill-swallowing techniques. Several seemed to help, including flavoured swallowing spray, a special pill cup and just practice with a regular cup and fake pills or candy.

Here’s more about pill-swallowing: Hard to swallow: Swallowing medicine is hard for at least 1 in 10 kids, Bradford said. Taste, pill size, fear and discomfort are among the reasons. The result can be missed doses of prescribed medicine and worsening

of symptoms it’s meant to treat. Some tested techniques: Research is scant; five studies published since 1986 were reviewed. A technique used in two studies started with tiny dummy pills, moving up to regular-sized tablets. Children were taught to sit up straight, place the pill on the tongue and swallow with water.

A special pill cup helped in a different study. One model has a spout for the pill, releasing it when the water is sipped. But most kids learned using a regular cup, with practice.

In the other studies: swallowing with the head in different positions including chin-up or turned to one side worked for some; as did throat spray to mask the icky flavour and help pills glide down. Grain of salt: While each of the methods studied helped some kids, the studies were generally small and had limitations, including a lack of followup to see if benefits lasted long after the studies ended. Bradford said swallowing methods should be tested in larger, more rigorous research. Her study was published Monday in Pediatrics. Why not crush: Crushing pills into food isn’t generally advised — particularly for extended-release medicine because crushing can release a higher-than-intended dose all at once. Also, some pills’ medicine flavour can’t be disguised, Bradford said. Make it fun: There probably isn’t a one-size-fits-all swallowing technique, but making pill-taking fun instead of punitive is helpful, Bradford said. At her hospital, kids are encouraged to think of tongues as water slides, and swallowing a pill gives it a ride into the stomach.