The art of pill-swallowing

How to teach children and young people to swallow pills

By Dr B.J.C.Perera, 
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL) 
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.

Many parents and caregivers know to their cost that getting children, adolescents and even young people to take medicine is an absolute nightmare. It is made much worse by many a child simply refusing to swallow all medicine including pills and tablets as well as syrups and suspensions. Please believe me, children are whimsical creatures who can make you tear your hair out at the drop of a hat.

However, taking a little time to get around them to teach children how to swallow pills and tablets has several advantages. It is very definitely, time well-spent in trying to teach the little ones to swallow pills and tablets. From a medical perspective, a majority of children above four years of age are technically able to swallow medicines in the form of pills and tablets.

From many a standpoint, getting children and young people to swallow medicinal pills rather than taking them in the form of fluid suspensions or syrups has a HUGE advantage.Many suspensions and syrups taste horrible and quite a lot of the little ones tend to spit them out or throw up the lot after swallowing, leading to a situation of uncertainty as to how much of the medicine has gotten into the child. Syrups contain sugar and preservatives; not the very best of things for a child. You are more likely to ensure that the medicines get into the child properly if the little one can swallow pills and tablets.

The pills and tablets have a greater shelf-life, do not require to be stored in a fridge, are easier to transport and very definitely cheaper. Many pharmacies, including those in state hospitals, have better stocks of pills and tablets of the same medicines rather than the same in liquid forms. Besides, to get the proper dose of the medicines into them, one may need to get the child to swallow rather large amounts of suspensions and syrups of terrible-smelling liquids with a nasty taste. For us the prescribers, there are fewer chances of making prescribing errors and it has the advantage of our being able to order larger quantities, especially for medicines that need to be used in the longer term. For many such reasons and the fact that most medicines are in pill form, swallowing pills is an important life skill for children to learn. There are concerted efforts undertaken in the developed world to teach children to take pills and tablets. It is most definitely the time for us in the developing world to follow in those very same footsteps.

This article is a simple guide to enable parents and caregivers to teach this important life skill to our little children. Some of the information and the images have been secured from programmes in Western countries and proper attribution to the site is provided below.