Teaching Your Child The Fine Art of Swallowing Pills and Capsules

For any parent, getting children to take their medication can be a frustrating experience. The flavor of a liquid such as Prednisone may be off putting to a child. You worry about spilling liquid medications or dosing accurately. That’s why I find that teaching children as early as possible to swallow a pill or capsule to be a wise idea.

You may wonder “Why worry about teaching my child how to swallow a pill or capsule now?”

First, some medications only come in solid form. To be honest, there aren’t many but there are a few.

Second, pills and tablets are much easier to travel with and don’t require refrigeration. Think about toting around that bottle of antibiotic next summer on your next family trip. Not fun!

Third, you will never have to worry about spilling or dripping a liquid again. Plus the dosing on a pill is accurate. How many times have you gotten to the bottom of the bottle of liquid medication and not had the full teaspoon?

In my experience, children as young as age 3 or 4 can learn to swallow a pill. I taught my own daughter who was not yet 3 to swallow pills. While a few teens can’t seem to master the skill, children are quick learners and repetition and patience along with some simple tips can help if you start children young.

It’s also a good idea to teach your child these techniques before they really need them. A sick little child is not great student!

WHAT YOU WILL NEED

• Multi-colored round candy balls called mixed decors found in the cake-decorating section of a supermarket
• Tic Tacs (I think the fruit flavor works best)
• Mini M&M’s
• Reese’s Pieces or M&M’s

THE TECHNIQUE

• Start with the smallest candy ball from the cake decorating kit. Explain to your child that you are going to teach him a simple way to learn to swallow pills and that it starts with learning to swallow candy balls. (Now is a good time to explain that medication is NOT candy but that you are using candy because it is an easy substitute. Explain that you should NEVER take medicine without permission of Mom or Dad).
• Parent should demonstrate by putting a single candy ball as far back on your tongue as possible, use the straw technique, and take three gulps of water.
• Tell your child it’s their turn. Also tell them that if the candy doesn’t go down the first time, they have to try at least two more times. If it doesn’t go down by the third try, they can chew the candy ball and take a break before trying again.
• Repeat this until they get comfortable with a candy ball, usually about three successful tries. Then move up to a slightly larger candy (I like to use the bigger cake decorating sprinkles, then move up to mini M&M’s) and repeat the procedure until there is success at this level.
• After three to five successes with the mini M&M’s, move up to a larger candy like an M&M or Reese’s pieces. After they have mastered that, compare it to a pill size wise. At this point they should be able to swallow most pills with minimum problems.
• Remember to limit the “session’ to 15 minutes. This will be a Process that requires days, perhaps weeks depending on your child.

SOME TIPS

• Have your child take a few sips of water before beginning. It is very difficult to swallow a pill or tablet with a dry throat.
• These tips works best if your child is thirsty. He/She may be drinking quite a bit, practicing their pill swallowing technique.
• Session should last no more than 15 minutes and be fun.
• Room should be free from distractions. Leave toys in another room and turn of the television.
• Stay calm and positive.
• Be patient, this is a task that will require some time.
• Demonstrate pill swallowing to your child in matter of fact way. When they see you do it calmly they will want to emulate you.
• Use lots of Positive Praise! Avoid negativity. This is not going to motivate your child to learn to swallow pills/tablets.
• Be consistent.
• Have your child put the pill on his/her tongue. Then using a straw, suck down three big gulps of water. With a straw there is no pill floating around in your mouth like there is if you just try to swallow a pill with a big mouthful of water.
• If water isn’t working try milk, a fruit smoothie, Pediasure, a milkshake, or fruit juice or nectar. Thicker fluids create more bulk, making it harder for the pill to separate itself from the fluid during swallowing.
• Always end with a success. If your child has difficulty swallowing a large piece of candy, end by having him swallow a smaller piece or even a gulp of liquid. Always end on a positive note.
• When swallowing a pill, have your child tilt their head back slightly. With capsules (which float), you do just the opposite. Have your child look down at the floor and swallow the capsule while still looking downward at the floor. The capsule should just float to the back of his mouth and slide down his throat with his drink.
• Make sure you have your child place the pill or capsule in the center of their tongue rather than to the right or left, especially if they are going to be swallowing an oval-shaped pill. An oval-shaped pill should be placed so that the length is parallel to their throat. Otherwise, the pill may go into the throat “sideways” and create discomfort.

DON’T

• Don’t break a tablet in half if it is too large. When you do this the rough edges can be scratchy and even more difficult to swallow than a larger smooth tablet.
• Don’t take pills with a dry mouth. It’s more difficult to swallow when your mouth is dry, and capsules and tablets may even stick to a dry tongue.
• Don’t bargain or bribe your child. After all you don’t bargain or bribe your child to brush his or her teeth or comb their hair. This is a skill they WILL learn. It just takes time and patience.

The techniques I shared with you should help you, help your child become proficient at swallowing pills and tablets. This is a skill that is a necessary part of life and when learned early can really be a very handy tool for a child to possess.

Remember to be consistent, patient and use positive praise and these techniques will have your child swallowing pills, tablets and capsules in a reasonably short time!

Outdoor Fun for Allergic Kids? Absolutely! Just Be Prepared

After the cooler weather subsides and winter seems far behind us, many of us are all too ready to head out into the sunshine. The feeling of freedom from monitoring our indoor allergies, the wonderful warmth on our skin during warmer days and splashing around in a pool make our days a little less nerve-wracking. For parents, watching our children run freely and breathing fresh air leaves us exhaling and settling into a season of hopeful happiness. For children, it’s a time of year to peel off your socks, kick off those shoes and rip off the heavy clothing so that they can feel the sunshine on their faces again.

Without thinking, we bound into the next season but where there is an all too perfect scenario, there may be some circumstances that catch us off guard. Of course those with allergies always have that silent voice in the back of their mind telling them to be cautious, to be prepared. But what about symptoms that leave us concerned and unsure of what the safety of our health is? How do we know what to watch for so that we can be as prepared as possible and be able to tackle it with less anxiety?

Knowledge about allergies and allergy triggers is always being updated. The best way to combat a situation is to have the necessary information to assess the situation before or as it happens. Although it is impossible to know everything that could happen, there are some factors that may be able to be prevented or, in the very least, considered so that you stay calm and save the meltdowns for another time. A key element to remember is that not all symptoms come from foods.

Urticaria Also known as hives. Anyone with food allergies often associate hives with coming in contact or ingesting an allergic food. Because hives are commonly a red flag to what we need to avoid next to prevent anaphylaxis, the appearance of hives may cause us to jump to the worst case scenario. Without a doubt, always err on the side of caution first however urticaria can also appear from other triggers that may not be as severe or life-threatening. Some forms of urticaria are caused by:

• Water – Aquagenic urticaria are hives that appear when the skin comes into contact with water, regardless of the temperature. Once the water is removed, the hives usually disappear within approximately 30 minutes.
• Sunlight– Also known as photosensitivity, this form of urticaria is believed to be caused by the immune system reacting to sun-exposed skin as it thinks it’s a foreign item. Exposure time that sets off the reaction can begin with as little as just a few moments in the sunlight. Because the severity of exposure varies from person to person, it is best to discuss your symptoms with your physician.
• Plants– Our skin is delicate and since it’s our first line of defense, it makes our skin more prone to fighting off anything that feels unlike what is supposed to be us. This means that sometimes just passing by a plant that you are allergic to or other plants with oils (such as poison ivy or oak) tells our skin that there is an invader about. You can protect yourself with long sleeves and pants, get tested for environmental allergies and always wash up with soap and water to avoid spreading to other areas of your body that was not exposed.

Alpha-Gal allergy has been an increasing story lately. For those who haven’t heard, this is an allergy to red meat but also (possibly) due to some ingredients in medications that “includes antibodies derived from animals” from the bite of the lone star tick. Most of the symptoms of alpha-gal allergy are similar to typical allergic reactions however anaphylaxis is said to be delayed after eating red meat versus an immediate onset that happens with typical food allergies. While many of us are trying to avoid ticks due to Lyme Disease, the thought of developing an allergy to foods from a non-food source introduces a brand new set of fears. Avoiding ticks is a given but consulting with a physician and having two auto injectors on hand for possible future anaphylaxis is a must along with a new food plan that will not include red meats or medications that contain ingredients from mammals. Auto injectors are typically prescribed for those with food allergies and although this allergy may be somewhat difficult to pinpoint, having two auto injectors to prepare you in the event that a future allergic reaction occurs will keep you one step ahead of an unexpected emergency but two steps ahead of your immune system’s safety as well.

With all of this being said, don’t fear the warmer weather, embrace it. Teach your family how to spot symptoms and how to play safely. Always use the buddy system and carry all of your necessary allergy medications to be one step ahead of the unexpected. Above all, remain calm and remember that life is too short to let any allergy keep you from spending time with your family.

Child Health & Safety News 5/28: Can You & Baby Safely Co-Sleep?

In this week’s Child Health News: What’s Going On In Your Child’s Brain When You Read Them A Story? The “Goldilocks effect” studied n.pr/2GULEKS

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use social media to communicate relevant and timely health and safety information to the parents, medical professionals and caregivers who follow us. Occasionally we overlook something, but overall we think we’re doing a pretty good job of keeping you informed. Still, quite a bit happens every day – so to make sure you don’t miss anything, we offer you a recap of this week’s top 25 events & stories.

• For a child to learn his feelings truly matter, adults in his life need to fully listen, respond and reflect in the moment. http://bit.ly/2b3Biy8 2018-5-27
• Use Healthy Discipline so Children Can Feel Good About Themselves bit.ly/2GQHTGa 2018-5-27
• Should You Give Your Kids Gummy Vitamins? bit.ly/2sbGfcZ 2018-5-27
• For Troubled Kids, Some Schools Take Time Out For Group Therapy n.pr/2s4ldxQ 2018-5-26
• Child campaigners to Zuckerberg: scrap Messenger Kids bit.ly/2GN7O1D 2018-5-26
• Why Campus Shootings Are So Shocking: School Is the ‘Safest Place’ for a Child nyti.ms/2x6y4nQ 2018-5-26
• Australian gymnasts and staff to be trained to identify child abuse bit.ly/2kmo3tN 2018-5-25
• Closing coal and oil power plants leads to healthier babies, study suggests ind.pn/2s4dujh 2018-5-25
• Advocating for Life Support Training of Children, Parents, Caregivers, School Personnel, and the Public bit.ly/2KRzKnt 2018-5-25

PedSafe Child Health & Safety News TOP Headline of the Week
Is Sleeping With Your Baby As Dangerous As Doctors Say? n.pr/2IPtHPo
…are there ways to make it less of a risk?

• Tomorrow morning, Show Dogs is an AMC #SensoryFriendly Film bit.ly/2IzutAe 2018-5-25
• Kids Who Care newsletter #9 – Radical Community and Radical Compassion getrevue.co/profile/pediat… 2018-5-25
• Brazil’s austerity measures could increase avoidable child deaths | bit.ly/2IFkQDX 2018-5-24
• Baby Health: Importance of Tummy Time bit.ly/2IExQdb 2018-5-24
• May 25th is National Missing Children’s Day bit.ly/2GMRpKr 2018-5-24
• 5 Beach Safety Tips for Family Fun – Thurs Time Capsule 06/11- bit.ly/2km556w 2018-5-24
• The Benefits of Summer Camp are Lost When Smartphones Intrude bit.ly/2IDleis 2018-5-23
• Prenatal Testing: Do You Know the Benefits and Limits? by the Cleveland Clinic cle.clinic/2x5begu 2018-5-23

PedSafe Child Health & Safety News #2 Headline of the Week
SAT or ACT: How to Know Which Is Best for Your Special Needs Child u.org/2IXyGRt

• Video: Breach Births – Choices for Moms to Be bit.ly/2s0YUc1 2018-5-23
• Road traffic a global health crisis, killing 350,000 children a year bit.ly/2IZ6Lk8 2018-5-23
• Additional Recommendations on Safe Sleep Environments for Infants bit.ly/2kgiBIS 2018-5-22
• 13 Reasons Why: What Parents Need to Know About This Netflix Series bit.ly/2rUrBHN 2018-5-22
• New App Helping MO Firefighters Treat Children Introducing Handtevy bit.ly/2kfp6LG 2018-5-22
• When Will My Kids See Their Grown-up Smile? bit.ly/2KEr2c2 2018-5-21
• Tomorrow Night at AMC, Deadpool 2 is Sensory Friendly bit.ly/2kawbgC 2018-5-21
• Ozone exposure at birth increases risk of asthma development bit.ly/2k9FmOk 2018-5-21

What to Do if Your Child Loses a Baby Tooth Too Soon

While baby teeth are not permanent and only last in a child’s mouth for a few years, they have an important role in the development of the jaw, muscles, and adult teeth. It is natural for baby teeth to fall out as the permanent teeth grow in to take their place. However, if a baby tooth is lost too soon, it can sometimes prevent proper development in the mouth. It may be necessary for your child to have a space maintainer put in to keep the space open until the permanent tooth comes in. This can save your child from extensive orthodontic work in the future.

Baby teeth can fall out early for a number of reasons. The most common causes are accidents resulting in tooth loss, or having to extract a baby tooth due to severe decay. Sometimes a baby tooth doesn’t even grow in at all. Whichever the case, an empty space in your child’s mouth can cause problems if the permanent tooth doesn’t grow in soon after. The teeth around the space can start to tilt and shift, resulting in insufficient space for the adult tooth to grow it.

A space maintainer can prevent improper development by keeping the space open until the permanent tooth grows in. There are several different types of space maintainers that can be used for treatment. Older children who are responsible in the care of their teeth might use a removable space maintainer. This appliance looks much like a retainer and is usually plastic. Other methods involve a fixed space maintainer, which is banded or cemented in place and is usually made of metal. Your dentist will help determine which type of space maintainer will work best for your child’s needs, and will make a custom appliance using impressions of your child’s teeth. The space maintainer is removed once the permanent tooth is ready to erupt.

If your child loses a tooth early, make an appointment with your dentist to discuss whether or not a space maintainer is necessary for development. While losing a baby tooth early does not always lead to complications, it is safe to have a professional’s opinion before letting it go too long. A space maintainer is a fairly simple solution to guiding teeth into place, and can prevent your child from having to endure a year or more of complicated orthodontic treatment.

I’m 9 Years Old – Do I Really Still Need a Booster Seat?

My son doesn’t want to use a booster seat anymore. I can see his perspective: none of his friends use one any longer and he thinks the seat belts in our cars fit him just fine. So why bother?? Because he’s just nine. And because crash studies and child safety guidelines from experts like the American Academy of Pediatrics indicate that he still needs to be using one. Although he thinks he’s so smart and grown up, he’s just a kid – and I’m the parent. And I actually know what it feels like to be injured in a car crash.

Guidelines issued by the American Academy of Pediatrics in 2011 recommend that kids use a booster seat until they are at least 4’9” tall (57 inches) and weigh between 80 and 100 pounds. This will likely be around the ages of 8-12 years. But it’s the physical dimensions that matter most. Kids need to be large enough to fit properly in the seatbelt – and mature enough to ride without slouching down and defeating the whole purpose of the belts. Focusing on the age of the child to guide booster seat decisions can be misleading. Last spring – at 9-years of age – my son measured in the 75th percentile for both weight and height at his annual pediatric visit (meaning he was taller and heavier than 75% of other nine-year olds)….and he STILL DIDN’T meet the criteria for graduating from a booster seat – he’s not yet 4’9” and weighs only just over 80 lbs. So why are we in the minority in our community in still using a booster seat?

The problem is that many state laws – and therefore local communications about what constitutes safe car travel for older kids – haven’t caught up to these recommendations (click here for a summary of state laws on child passenger safety). Many states – like Alabama, Colorado, Iowa and Nebraska (to name just a few) focus exclusively on age – without the all-important height and weight requirements. This list includes my state of Indiana which allows children over age seven to shelve the booster seat, no matter how big they are. My son’s best friend – also nine – stopped using a booster seat last year. He’s fully THREE INCHES shorter than my son. How can he possibly be safely restrained by an adult seat belt during a crash? And this isn’t just a theoretical issue. Safe Kids USA reports that children seated in a booster seat in the rear of the car are 45% less likely to be injured in a crash as compared to those using a seat belt alone.

While this is bad enough, some states – like Florida, Arizona and South Dakota don’t even have booster seat laws. In these states it is legally permissible for children as young as age 4 and 5 to use adult seat belts. Is there some reason why the children in these states are less likely to be involved in a traffic accident – or that they are somehow more resilient in a car crash?

Let’s face it – the process of proposing and passing laws is complicated and time-consuming. Hopefully all these states will eventually get on par with the guidelines, joining states like Georgia and Maine. However, in the meantime it’s our children riding in the back seat and I would rather base my car safety approach on best-practice guidelines than rely on the timeline and politics of my state judicial process.

So, in our house the 4’9” rule prevails. We even got out the measuring tape recently and determined my son has an inch to go. He’s counting down every day. And he understands that I’m following new expert recommendations to keep him safe – and that his friends’ parents probably just aren’t aware of these guidelines, which is too bad.

Bronchiolitis or “Wheezy Bronchitis” and Kids

One of the more common illnesses that is encountered during the winter months in infants and young children is a respiratory problem referred to as Bronchiolitis or “wheezy bronchitis”. This is a condition caused by a viral infection that attacks the respiratory tree, both upper (nose and throat) and lower (the smaller airways leading to the air sacks in the lungs). It is most commonly caused by RSV or Respiratory Syncitial Virus. It can also be caused by other winter time viral infections but the exact cause is relatively unimportant as the symptoms are nearly the same.

Your child will usually develop signs and symptoms of a regular cold with sneezing, runny nose, mild cough, and sometimes a low grade fever. At this stage it will be impossible to tell if this will progress to bronchiolitis, but most of the time this will remain a cold and your “cures” are limited as your doctor will tell you. In a certain number of infants and young children, after a few days of the cold, the cough might progress to a more significant stage and the infant or young child may show some signs of having difficulty breathing; more rapid breathing rate than normal will usually be the first of such signs, but fever alone can raise an infant’s rate of breathing, and if you are unsure call your baby’s Doctor and he/she will help you figure that out.

Because the primary problem with bronchiolitis is swelling in the respiratory passages (lower and upper), air might have to begin to squeeze through narrower passages in the lungs and similar to what we have presented about asthma in the past, this may lead to wheezing. Wheezing is a whistling (musical) type of noise when your child breathes out versus noisy breathing in noticed in those infants with the upper airway cold. Admittedly this may be difficult to see by non- medical parents, but you can ask your Doctor how to do this in a reliable and repeatable manner.

Most infants and young children will remain in this stage and, as long as he/she is feeding well , does not have fever over 103, and seems fairly cheerful with his/her usual skin color, you do not need to worry, and all the symptoms will resolve as the cold goes away.

Occasionally, the situation can worsen with more difficulty breathing, now showing itself by your child using more muscles of his/her body to help force the air through the small airways in the chest: those muscles might include the abdominal, neck and intercostals (muscles between the ribs). At this stage your child should certainly be under the care of a physician, who might, depending on the appearance of your child admit him/her to the hospital so that more intensive care can be used to help him/her breathe.

The illness is self limited in that between 3 and 7 days normal resolution will take place. The worsening progression that I outlined above will generally not happen very fast and you will have time to see that your child is getting worse. Anywhere along the way, should you have doubts about your ability to adequately monitor your child’s status you should be talking to his/her Doctor.

I would like to stress once again that most bronchiolitis illnesses in infants and young adults remains mild and in fact may be indistinguishable from a normal cold.

If you would like to hear more about bronchiolitis please leave me a note in the comments below