Pill-taking is hard & yucky for some kids; studies show some techniques may help, review finds

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 flavored swallowing spray, a special pill cup and just practice with a regular cup and fake pills or candy.

Here's more about pill-swallowing:


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.


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 flavor and help pills glide down.


While each of the methods studied helped some kids, the studies were generally small and had limitations, including lack of follow-up 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.


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 flavor can't be disguised, Bradford said.


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.



Pediatrics: http://www.pediatrics.org

Safe medication practices: http://www.ismp.org/Tools/DoNotCrush.pdf .


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner