“Just a spoonful of sugar helps the medicine go down…”   I’m going to take a break from talking about child sexual abuse (yay!) and channel my inner Mary Poppins for the day. Imagine me cheerful, sing-songy, dancing around with my tote and umbrella, butterflies and birds chirping around my head. It’s a stretch, but this is how I try to present myself to the big and little kids who come see me in my pediatric clinic. I’m happy, bubbly, and I get to tell them truthfully, “Don’t worry! I don’t ever give shots!” since I don’t do well-child exams. Occasionally, I even dole out some crazy advice for the parents. My favorite piece of advice over the years is “Go buy your kids some M and M’s.” Yes! Several times a week I am actually writing on the child’s take-home instructions: “M and M’s”. Let me tell you why.

The average kid does not know how to swallow pills until they are 10-13 years old. But if taught early and properly, kids can actually learn to swallow pills as early as 4 years old!  My own kids learned when they were 6-7 years old. For most children (and adults), the trouble with swallowing pills is mental.  If your pre-teen son is anything like mine, when you give him a chunk of prime rib-eye steak he will easily swallow that piece of meat the size of a ping pong ball. On the other hand, that same kid will often choke and gag on a tiny little Advil tablet. I know you’ve been there. You’ve tried all sorts of things: mashed it, disguised it, hidden it in ice cream, stuck it in a milkshake. You’ve bribed, threatened, screamed, apologized.  But you still end up with what?  A kid full of mashed foods and ice cream shakes and a tiny little pill sitting on the tongue.  Rats!!

It’s not physical or medical, it’s mental. That’s where candy helps. When kids think of swallowing candy or chocolate, they are excited to do it. So let’s take advantage of that and teach them to swallow “pills” with this step-by-step process. M&M’s are great to practice on because they taste great, are tiny, and melt in the mouth.

Mini M&Ms, regular M&Ms, Advil, and Tylenol

What you will need:

small kid size cup of water

mini M&M’s

regular M&Ms (no peanuts or almonds)

optional: cake decoration sugar pearls

1.  First off, be very clear with them that medicine is not candy and vice versa.  You don’t want them learning that they should pop real pills because they think they’re candy.
2.  Have them practice drinking big gulps of water.  Not sips. GULPS!  Praise them for taking big gulps!
3.  Demonstrate you swallowing a mini M&M by placing on the middle of your tongue (not the back) and taking a big gulp of water. Show them the mini M&M is gone.
4.  Have them try it.  Have them put the mini M&M in their mouth, and tell them to gulp the water. Tell them to try it several times and if it still sits on their tongue after 3-5 attempts, they can chew it up and swallow it.  Wait a few minutes and try again.
5.  Each daily practice session should last only 10 minutes.  Praise them for trying.
6.  Keep a small bowl of mini M&M’s in the refrigerator and have them practice with a few each time they go to the fridge for a snack or drink.
7.  After a few attempts, few days, or even a few weeks of daily attempts, they’ll finally swallow their first one!  Be super excited!  Keep at it since it may take awhile for them to get it consistently each time.
8.  After they have mastered the mini M&M, buy some regular sized M&Ms and put a bowl of those in the fridge to practice next.  Once they have mastered the regular M&M, they can swallow an adult sized ibuprofen/Advil tablet and most other medications.
9.  Celebrate by letting them finish off the M&Ms, but also continue keeping a little bowl in the fridge so they can keep their skills up!

If they have tried with the mini M&Ms daily for a few weeks and they still can’t get it, take a step back to a smaller candy.  Try the Wilton sugar pearls in the cake decoration aisle of the grocery store.  Try these for a few days-weeks and once they have mastered those, move back to the mini M&Ms. Keep the mood positive and praise your child constantly during this process.

There are lots of reasons why your child needs to learn to swallow pills.  Liquid medicines often have a bad taste, can be more expensive and difficult to find at pharmacies, are more prone to incorrect dosing, often require refrigeration, and are more difficult to travel with. Also, the dosing as the child ages becomes much larger. I actually saw a patient this past week whose dad had just learned to swallow pills at the age of 37. The dad had a ruptured appendix and had to force himself to learn how to swallow pills to take his pain meds and antibiotics! He was so excited when I told him he could teach his 8 year old child how to take pills using my M&M “prescription”.

I hope this little medical advice tidbit helps some parents out there!  Share with your parent friends of all ages.

Now back to my regular programming….another set of Camp Careful classes for child sexual abuse prevention are this weekend on Sunday September 13th.  Please check out my website to register (https://www.campcareful.com/events/) and also subscribe to my blog for Camp Careful updates and pediatric health tips!

Empower your kids and stay safe!

Soo Battle, M.D., F.A.A.P.

Disclaimer: The information contained on this website/blog is for informational purposes only and should not be used to replace the relationship that exists between you and your pediatrician or doctor. Please contact your doctor for medical advice and/or treatment recommendations specific to your child.

“A Spoonful of Sugar” written by Robert and Richard Sherman in 1964 for Mary Poppins.