How to teach a child to swallow a pill

Most of us have the ability to swallow a pill because our nervous system functions the way it’s supposed to. But that doesn’t mean we can do it automatically. Swallowing pills is a skill.  

In fact, studies show about 25% of children cannot swallow a pill. But, says pediatrician Andrew Mutnick, MD, “swallowing a pill is really an advanced form of drinking. It can be mastered."

Here's how this Columbia pediatrician recommends using candy to teach a child how to swallow a pill. (Adults, you can learn too.)

The cardinal rule

The cardinal rule of teaching someone to swallow a pill is: Teach them when they are not sick. “Think of a basketball player who can hit every foul shot in practice but misses during a game,” says Mutnick. “Stress throws everyone off.” 

Speaking of stress, don't add pressure or have expectations. The problem, says Mutnick, is this skill is often introduced at a time of crisis—when someone is sick—adding a degree of difficulty. “From a kid’s perspective, the combination of being sick and meeting a parent’s expectations while attempting something new can be too much.”  

Mutnick admits he learned the cardinal rule in his own home by not following the cardinal rule. “Through unnecessary blood, sweat, and tears, we got it down,” he says. This does not have to happen to you. 

How to teach a child to swallow a pill 

Make this lesson fun and disassociate it from needing to perform. Stop if it's too much.  

1. Start when the child is not sick. 
2. Tell the child they’re learning now so that when the time comes, they’ll feel like a pro. Plus...candy! 
3. Set up a table with water and pieces of candy, arranged from smallest (a sprinkle) to biggest (something the size of a Good & Plenty is large enough). Tic Tacs and M&M Minis make good intermediates.
4. Have the child sit and sit up straight. 
5. Begin with a glass of water. Ask the child to take two or three sips to illustrate they already know how to swallow.  
6. Move to the smallest candy (the sprinkle).   
7. Put a piece of candy on the child's tongue. 
8. Have the child take two or three sips of water, as they did in step 5. Several small sips are better than one big, cheek-filling gulp. 
9. If successful, move to the next biggest candy and repeat steps 7-8. 
10. Celebrate! You did it.  

At any point, stop if it's not going well. Or go back to the sprinkle to finish on a win. If you need to try again, start on a different day and consider putting the candy into a spoonful of yogurt, applesauce, or something of similar consistency that the child likes. With the child watching, so as not to hide, submerge the piece of candy into the food—starting with the largest previous win. Ask the child to swallow the spoonful. If needed, offer a sip of water, too. Then repeat with the next largest candy.  

What's the right age to teach a child to swallow a pill? 

Kindergarten, Mutnick says. The ability to swallow a pill is present around age 5. It's not a guarantee, he adds, but most kids are successful between ages 5 and 10.