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Little girl with eleven years old covering her mouth and fearful of swallowing medication

Pill Swallowing Paranoia

By Amalah

Dear Amalah,

My daughter is 12, almost 13, and she still cannot, will not, even attempt to swallow any medicine in pill form. She has ADD and takes medication, but we’re limited to what comes in a capsule form that I can open up and mix into a spoon of yogurt or pudding. We’re fortunate that the med she’s on works for her, but…that’s ridiculous, right? To still be doing that every morning? 

The problem started when she was diagnosed and we decided to try the medication route and the first prescription we tried only came in a tablet. But a small one! I wasn’t really expecting it to be a problem. But she couldn’t do it. She was terrified she’d choke on it, and after a couple clumsy attempts at swallowing DID result in some gagging/discomfort this reinforced the fear. We backed off, tried again like six months later and the same thing happened. If anything it was worse.

So now the mere suggestion that she, oh, take a regular Tylenol for a headache instead of the children’s liquid sends her running to her room in terror.

She had some sensory stuff about foods and swallowing when she was a toddler so I get it. I doooooo. But I’m worried that as she gets older there’s going to be a real, unavoidable medical need for her to swallow a real pill and she won’t be able to. Help!

Pretty Sure They Don’t Make Birth Control Gummies

Ugh. Welcome to my childhood. I was also a kid whose mother used to drive to my school at lunchtime with a cup of yogurt in tow so I could take whatever weird antibiotic I was on, or to hide in the bathroom with me while I choked and cried and struggled to swallow a stupid pill.  (I had a ton of allergies so I was limited to ones that weren’t available in a child-friendly liquid, and was unfortunately raised in the age of ANTIBIOTICS FOR EVERYTHING ALL THE TIME!)

The weird thing is that I have no memory of when or how it changed for me. I just…could swallow pills at some point. NBD. And my oldest child — also ADHD and an oral motor/sensory nightmare as a toddler — also just…learned to swallow a pill when push came to shove. Here, take this, you’ll be fine. And he was.

And then there’s my middle child. Hooooooo boy. He was (mis)diagnosed as ADD as well and basically tongued an entire month of medication and hid it in his laundry hamper because he was too terrified to swallow it. All our early attempts at “IT’S FIIIIINE JUST SWALLOW ITTTTT” with a variety of liquids or hiding it in soft foods really didn’t go over well and, like your daughter, probably just reinforced his fear.

There are a lot of different gadgets people recommend — special pill swallowing cups, glide sprays and goo — but we didn’t have any luck with them. If he knew the pill was in there, somewhere, he’d just tense up too much and start to panic. (And this is a child who eats EVERTYHING so I knew there wasn’t a physical problem.)  So we went a different route.

We started with trying to swallow something really really tiny — a single decorating sprinkle. We did that over and over to get him used to the sensation of putting something on his tongue and taking a drink. Then we moved up in size from there, but stuck with actual familiar foods that he knew — logically — he wasn’t going to choke on. A single Nerd candy. A mini chocolate chip. The head of a gummy bear. (I should mention we did this post-Halloween, if that’s not obvious.) I demonstrated how a pill dissolves super-duper quickly (like the candy!) so it’ll start shrinking in size almost immediately.

He was still really, really nervous when it came time to try a real pill — a tiny seasonal allergy med — but he did it! And he was both super relieved and proud of himself. Fear officially conquered. I don’t know how he’ll do with anything larger, but we’ll cross that bridge only when we really have to.

For now I’m just happy to be rid of the collection of perpetually sticky dosage cups littering my countertop and realizing that the liquid allergy medication expired six months ago but I feel like we JUST BOUGHT IT WHAT THE HELL COME ONNNN.

Photo source: Depositphotos/Gelpi

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Carolyn Russell
Guest

Hahaha, we started with grains of rice, but a sprinkle would have been much more fun! 😉 But yes, start with making sure she knows how to take a big gulp of water all at once (because if you slowly sip it or put it all in your mouth and then slowly drink it, things will start to dissolve or get sticky, and as an adult that still freaks me out!) and then start with something itty bitty and move up from there. You could also use something yummy and maybe motivating to drink (my kids only ever got diluted… Read more »

Karen
Guest
Karen

Could she be tongue tied? People with restricted tongues have difficulty swallowing pills. If she has difficulty with sleep, there’s an overlap between ADD/ADHD and tongue tie.

MusicWithRocksInIt
Guest
MusicWithRocksInIt

Ha. This is so strange to me because as a kid I *hated* liquid or chew able medicine and it’s horrible horrible taste and begged to be allowed to take big kid pills that I could just swallow. But now I am pregnant and my gag reflex is out of control and I can’t swallow pills for anything. I have to chew up a bunch of food and stick the pill into the chewed food in my mouth and swallow the lot of it in order to keep my vitamins down. So maybe that is a way? But I am… Read more »

shayna
Guest
shayna

This was also me as a kid, although I **still** have trouble taking pills, and the downside for me (and my mom, haha) was that I also struggled with liquid medication, or mixing with food, which were also not doable for me. I finally learned a couple of tricks that help, that I still do to this day to some extent: one, instead of having her put the pill in her mouth followed by water (IT’S TOUCHING MY TONGUE IT’S TOUCHING I CAN FEEL IT I CAN’T CHEW IT I’M GONNA DIE), have her fill her mouth with liquid, then… Read more »

ELF
Guest
ELF

I couldn’t swallow pills as a kid, and I taught myself how. The solution was frozen peas (still frozen) (amazing snack!). For me, I couldn’t swallow without chewing, so I would put a spoonful of frozen peas in my mouth and hold one at the back like a pill, and chew the others, then swallow. Over time, I tried fewer other peas/ no other peas but still pretending to chew first, and eventually I could swallow them whole. By my late teens I could swallow giant horse-sized pills dry if necessary, because I had learned the swallowing motion so deliberately.… Read more »

Jaimy Bisbee
Guest
Jaimy Bisbee

I couldn’t swallow pills until I was pregnant with my first because when I was a kid it became a huge deal if I couldn’t do it the first time so it was just endless anxiety. What worked for me was taking the pills (only 1 at a time) with soda because the carbonation hid the pill so my tongue wouldn’t push it to the roof of my mouth. I’m starting to be able to take pills with other stuff, but it has to have a flavor. Maybe try her with something with bubbles because that seems to hold the… Read more »

Leigh
Guest
Leigh

My then seven year olds hack was to use in icee. Drink a bit. Then put the pill into the straw full of icee and keep drinking.
Side effects include gettin an icee which is why he likes it so much, but it got us over the hump.

Sarah
Guest
Sarah

I have always hated taking pills. And personally, I still can’t understand how anyone can stand to place a pill on their tongue and THEN take a drink of water. Pills taste AWFUL! My mom taught me to take a big mouthful of water, look up and open your mouth enough to drop the pill in, and then swallow the pill WITH the mouthful of water so it will never touch your tongue (or get stuck to it!). I still take medicine this way, and sometimes chase it with a cracker or something if I feel like I can still… Read more »