A guide for parents, caregivers and children over 4 years.

Download a colour brochure for this information.

Swallowing

We teach children not to swallow anything until it has been completely chewed and not to put strange objects in their mouths. It is only natural that they think they can't or shouldn't swallow a tablet.

Also, some people have narrow throats, sensitive palates or a very strong gag reflex which initially makes swallowing larger objects uncomfortable.

The plan

By starting with small lollies that are easy to swallow and slowly increasing to a larger size, children can learn to become comfortable swallowing tablets and capsules whole.

You will need

• Lollies, e.g. 'snakes', jelly babies (1 pack)
• Flavoured yoghurt or ready-to-eat dairy pudding (i.e. Yogo) (2 packs)
• Juice or milk
• Plastic knife and plate
• Spoon

Keep this in mind

• Make this a fun, relaxed project.
• Keep sessions short so your child doesn't become tired and stressed.
• Be flexible.
• Give plenty of praise for all your child's accomplishments along the way. Even little steps are important.
• If there is little progress, talk with the medical caregiver; do not discourage the child.
• Keep all medicines out of reach of children.

What to do

1. Give your child some control. Go shopping together for the food and let your child choose the yoghurt or pudding flavours.
2. Allow your child to cut the lollies into very small pieces and put them in the yoghurt or pudding. Ask your child to swallow them with the yoghurt or pudding.
3. Encourage your child to swallow the pieces of lolly without chewing. Suggest to the child that this may be done more easily if the lolly is moved toward the back of the throat.
4. Once the child can swallow small pieces, demonstrate cutting them a little bigger and repeat the process.
5. Once your child has mastered average tablet-sized pieces of lolly, thin out the yoghurt or pudding with a little milk and encourage the child to practise with this.
6. Continue until your child feels comfortable with this, then change to swallowing with water.
7. Buy some small empty gelatin capsules at a pharmacy. Practise each day with these capsules in water. Allow your child to handle them, pull them apart or chew them. They may even like to fill them with sprinkles before taking them.
8. Buy some larger sized empty gelatin capsules for practising.
9. Have your child swallow a vitamin tablet daily to keep in practice.

Other helpful points

• When learning to swallow, use warm rather than cold water to relax the throat.
• Mask bitter or strong flavours with ice cubes, licorice, fruit or chocolate.
• Any jelly-type lollies can be used.
• Substitute apple puree for yoghurt or pudding, if preferred.

Acknowledgements

We acknowledge the kind assistance and work of
Jean Hurwitz
Duke University Medical Centre
Durham NC, USA