The day will come when your child will need to swallow a pill. Some children have no problem swallowing pills; others flatly refuse or are terrified. Here are some strategies for helping your child master this important skill.

Pills vs Liquid Medicine

Medicines for children often come in liquid form. To make them more palatable, the unpleasant taste of the drug is masked with sweeteners and flavors. But in some cases, a child may hate the taste so much, she refuses to take it or spits it out. Then, your pediatrician may prescribe the medicine in pill form.

For some illnesses or medical conditions, pills are the only form of medicine available. Another reason for a pill vs. a liquid is the need for a delivery system. Pills can be designed to deliver medicine to the blood stream in a time-released or controlled way.

Pill-Swallowing Practice

Many parents wisely teach the skill of swallowing a pill before the need arises. It’s much easier to teach a child who is well and happy than one who is sick and irritable. Start practicing with tiny “pills,” then gradually increase the size as your child masters the skill. Here’s what to do:

  1. Buy several sizes of small, hard candies for pill-swallowing practice. Some examples are cake sprinkles, tic-tacs and mini M&M’s. Do not use any candies that are soft or gummy.
  2. Explain to your child that you’re going to help him learn the skill of swallowing a pill. Focus your attention on the child. Eliminate distractions.
  3. Sit with your child at a table. Put a few of the smallest candies on the table with two glasses of water. Demonstrate how to swallow a pill by doing steps 4 through 7 yourself.
  4. Sit up with your spine straight, head erect and shoulders back.
  5. Put a candy in the center of your tongue.
  1. Take a sip of water and swallow.
  2. Open your mouth and stick out your tongue to show that the pill is gone.
  3. Praise your child. Say, “You did a great job swallowing that pretend pill!”

Continue helping your child practice for several days in a row, swallowing two or three candies of the same size. Once that size is mastered, choose a slightly bigger candy and repeat the process.

Teaching Tips

Here are a few tips to keep in mind.

  • If the pill is “getting lost” in the mouth and isn’t being swallowed, try a smaller sip of water.
  • The candy should be swallowed right away so that none of the candy color gets on the tongue. For example, if your child swallows a blue mini M&M, there shouldn’t be any blue on the tongue.
  • Make the practice sessions fun and positive. Keep your tone of voice and attitude upbeat.
  • Focus your attention on desired behaviors. Even if your child doesn’t manage to swallow the “pill” during initial practice sessions, you can praise how good her posture is or what a nice job she did taking a sip of water.
  • Ignore behaviors that you don’t want to see increase, such as complaining or gagging. Withdraw your attention and don’t engage by giving negative comments.
  • Model pill-swallowing behavior in your home. Call your child’s attention to the steps as you are taking your own medicine or vitamins.
  • For kids who haven’t yet mastered pill swallowing, try putting a small amount of pudding, applesauce or yogurt on a spoon, then placing the pill inside. But check with your pharmacist before trying this. Some medicines shouldn’t be taken with milk products or food.


If your child has trouble swallowing a pill, talk to your pediatrician or pharmacist. Sometimes there are alternate forms of similar medication available, such as a transdermal patch.


Pill-Swallowing – Training Video

For children who are having pill-swallowing difficulty, check out “Better Than a Spoonful of Sugar” on YouTube. Dr. Bonnie Kaplan goes through step-by-step instructions using head posture practice. The child learns to swallow pills with the head turned left, right, up and down. Each day for two weeks, the child swallows one small candy in each of the five positions and rates the ease of pill swallowing with a thumbs up or thumbs down. After two weeks, the child chooses the head position he likes best. In her study, all 33 children who participated using this method successfully overcame their difficulties.


Brenda Schoolfield is a freelance medical writer who splits her time between Austin and Seattle.


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