Tablet Swallowing Advice for Children and Young People

Tablet swallowing advice for children and young people

Why change to tablets?

• Oral suspensions (liquids) can have an unpleasant taste, contain high levels of sugar and additives, and require large volumes for higher doses.
• Suspensions have a much shorter shelf life than tablets, leading to more repeat prescriptions and the need for refrigeration, which can be difficult when travelling.
• Suspensions need to be shaken well to ensure the active ingredients are evenly mixed, as they tend to settle at the bottom.
• Suspensions are much more expensive compared to tablet equivalents.
• All of the above have significant environmental effects, and changing to tablets can have a positive environmental impact.

These factors can help taking regular medication easier and reduce unnecessary stress around medication use. It is easier to manage medications in the form of tablets and we will teach you how to help children and young people (CYP) learn to take them.

Offer choices to your child
When children and young people undergo medical treatment, they may face challenging tasks, making them feel powerless. To regain control, they may resist taking medication.  If you are experiencing this, try not worry as it is very normal.

While supervising and helping your child to swallow medication allow them to have a say in their medication routine. It can be helpful to let them administer the medication themselves and make small decisions such as:

• Choosing the time of day to take the medication (if possible).
• Deciding where they will take the medication.
• Selecting who will be there to encourage them.
• Picking a drink (non-fizzy) to have while swallowing preferably in a sports type bottle.
• Choosing how long to practice, ideally between 2-5 minutes.
• Deciding what to practice with (e.g. bread, Smarties, Tic Tacs, M&Ms).

Practice tablet swallowing
Start by practicing with small sweets or cut up sweets of varying sizes. Gradually increase the size as your child becomes more confident. If they are nervous about taking tablets, remind them that the food they swallow is often larger than a tablet.  Another method is to roll small pieces of bread into tablet shapes. This allows you to create different sizes for them to practice with and progress similarly to using sweets.

There are a few ways that people find helpful to swallow tablets so you may want to try a few with your child and get them to choose which one works for them.

• Have your child sit up straight with their drink of choice in a sports type bottle. (non-fizzy!).
• Take a few sips of the drink first so their mouth is not dry. 
• Get your child to put the medication in the middle of their tongue.

Followed by:

 Option one:

1. Ensure your child has their lips tightly around the bottle opening to encourage a sucking motion. 
2. Try to avoid them throwing their head back as their head should naturally go back with the bottle.
3. Take 3 big gulps of drink

OR Option two:

1. Take some water but do not swallow.
2. Get them to look down and try to put their chin on their chest.
3. While their head is down take a big gulp and try to swallow the tablet with the water.

OR Option three:

1. Take lots of sips of water and swirl it around in their mouth for 10 seconds.
2. Take another big gulp!

OR Option four:

Sometimes using certain foods, for example chocolate mousse or yogurt, can help to act as a “vehicle” to carry the tablet and make it easier to swallow

Create a consistent routine
Establishing a regular routine for taking medication can help reduce fear and anxiety and provide stability and structure. Choose a consistent time and location for administering the medication based on the prescription’s instructions. For instance, you might give your child their medication after dinner in the kitchen every night. Minimise noise and distractions during this time and offer a small treat or allow them to watch their favourite show as a reward afterward.

Stay positive and manage fear
If your child struggles with taking medication, it is essential to remain calm and positive, even when it is challenging. Showing frustration can increase their anxiety. If your child becomes upset or starts crying, the chances of gagging or vomiting the medication can increase. Practice in short sessions so you can both take breaks and reset if needed. Try and keep the process as low-pressure as possible. Swallowing tablets can be psychologically difficult, as children may be scared of choking or disliking the taste. Offer reassurance, praise, and stay by their side to build trust. When they succeed, celebrate their progress to boost their confidence for the next dose.

Incorporate play into medication time
For younger children, make the experience more engaging by introducing play. Let them pretend to give medication to a doll or stuffed animal. Give small rewards, like a sticker chart, offering a bigger reward after several successful doses.

If you think it might help you can use different playful analogies to help explain e.g., that their throat and tongue act like a ramp and the tablet is like a car they need to wash down the ramp or the tongue is a rollercoaster to go down.

Explain the “why” behind the medication
Be sure to explain how important it is that they take the medication.  Help your child understand that it’s not just a requirement, but that it was prescribed by the doctor to help their body heal and feel better.

Common mistakes when teaching tablet swallowing

• Forcing them to swallow under pressure, especially in a stressful environment.
• Starting with something too large, which can discourage them.
• Making practice sessions feel like a chore—keep them short and positive.
• Trying to practice when you’re in a rush, which adds pressure to the situation.

In summary, five simple steps for teaching your child to swallow tablets

1. Keep practice sessions short and positive
2. Use small rewards or incentives
3. Teach them proper swallowing technique getting them to try and choose from the three options above.
4. Start small and gradually increase size
5. Be patient and flexible

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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