Training can ease pill swallowing problems even in young children

Children’s difficulty in swallowing pills is commonplace and can be a barrier to the child receiving optimal medical care. A recent review of published studies on this problem indicates that interventions, even in children as young as 2 years old, can yield positive results.

Training can ease pill swallowing problems even in young children click to enlarge Drs. Bradford and Jhaveri

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Monday, April 20, 2015

Difficulty in swallowing pills is a common pediatric problem, affecting an estimated 20 to 30 percent of children. Despite the issue’s prevalence, a review of related studies out of the University of North Carolina, and published in the May 2015 edition of the journal Pediatrics, suggests such challenges can be effectively mitigated using a variety of techniques.

“Children can have problems swallowing pills for a variety of reasons,” explained the review’s lead author, Kathleen Bradford, MD, a professor of pediatrics in the UNC School of Medicine. “Difficulties can be behavioral in nature, related to anxiety, or stem from pill itself—the size, texture, or flavor—or the actual physical skill needed to swallow a pill. Whatever the cause, these problems can extend into adolescence and even adulthood.”

Bradford and her coauthors evaluated related studies published between December 1986 and December 2013 that included more than 10 participants between the ages 0 to 21 years with pill swallowing difficulties unrelated to a physical malady. They found five studies that fit the criteria of participant numbers, soundness of method, and other predetermined factors. Each one of these studies demonstrated improvement in pill swallowing after intervention.

“Although the data is very limited, the studies we found suggest that pill swallowing problems can be overcome,” said UNC School of Medicine coauthor, Ravi Jhaveri, MD, an associate professor of pediatrics. “Effective interventions include behavioral therapies to reduce anxiety, head posture training, flavored sprays, a special pill cup, and verbal instructions.”

These extend to very young children, including those as young as 2 years of age. In fact, one study found that younger children (aged 4 to 5 years) needed less training to learn how to swallow pills.

The authors stress that further research is needed on this problem in order to discover the best means of identifying children with pill swallowing difficulties and implementing targeted interventions before it is medically necessary for the child to swallow pills.

“The take home message is that pill swallowing difficulty is not an uncommon problem, and there are resources available to help children with these challenges,” said Bradford.  

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