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 trip to the Bahamas. 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!

Shopping cart safety

While shopping at the grocery store, it’s quite common to see young children climbing on and standing up in shopping carts. Although safety belts have been available for many years on most shopping carts, there are still an estimated 21,400 children under the age of five who are treated in U.S. emergency rooms every year because of injuries sustained from shopping carts. Most of these injuries are head injuries due to falls from not being properly restrained in the child seat of the cart.

Most children love to climb and do not enjoy sitting still for long periods of time. So parents face the challenge of keeping their kids restrained and entertained while shopping and may be tempted to let them climb on the cart or ride in the basket just to keep them happy. Or a child may get out of the restraint belt while mom or dad is preoccupied with shopping. So how do you keep your little one safe while you shop?

Here are some tips to help.

Always use the seat belt/safety strap

Children who are properly restrained in the child seat of a shopping cart are much less likely to fall out of the cart so make it a rule that if your child is in the cart, the strap has to be fastened securely. This should be non-negotiable with your child, just as seat belts and car seats in the car are a non-negotiable rule when riding in the car. Infants who are not able to sit up without assistance should not sit in a shopping cart seat unless it has a built-in infant seat with a harness restraint system. Never allow kids to climb on the cart or ride in the basket. Older children should not push the cart if younger children are riding in it and should not be allowed to ride on the outside of the cart, as this could cause the cart to tip over.

 Use a shopping cart cover

Shopping cart covers help protect kids in two ways. First, they cover the seat and bar of the shopping cart which protects from germs and provides some padding, making the ride more comfortable. Secondly, some covers provide extra safety straps to provide a more secure ride. There are numerous covers available in a wide variety of styles and designs so you may want to shop around to find the best one for your child’s needs. Some even have toys attached to the cover to provide entertainment during the trip through the grocery store. When shopping for a cart cover, make sure it is large enough to fit over the child seat and bar of the shopping carts you most often use and check whether or not it has its own straps to restrain the child or if you have to use the straps on the cart.

Engage your child in the shopping experience

If your child feels included while shopping, he may be more likely to sit safely in the cart through the whole trip. Talk with him about the choices of products you are buying. Let him help pick out some of the items, if he’s old enough and talk about what you will use the items for at home. If your child is old enough, let her help you read the grocery list and check off items as they are put in the cart. Or she can hold a calculator and add up the cost of your purchases. Even toddlers can be involved by using a list with pictures instead of words or using a cheap calculator and let them pretend to add up purchases. Keeping your child involved and entertained can not only make your shopping trip safer, but also more enjoyable for you both.

 Use these tips to protect your child from shopping cart falls and injuries every time you shop!

“Best of” Back-to-School Health and Safety Tips 2009: Part II

If you are a parent or someone who takes care of kids in any way, shape or form (which I’m guessing you are if you’re reading this) there are three words that have dominated your world for the past couple of weeks: “back to school”.  It is likely that you have not spent a day, opened a newspaper or a journal or gone to the sites you typically visit on the internet and not seen these words staring back at you in an article telling you: “How can you best prepare your kids”, “The 101 things you should know before sending your kids back to school …” etc.  Sometimes it seem like there are a million articles…by a million experts. Unfortunately, with so much information it can be a bit overwhelming at times, when all we really want is someone to give us the answer to the very basic question of “what should I do to handle this particular situation.”

So for those of you who didn’t read part I, I’ve gone through all my sources and created a “best of” health and safety tips across all the expert information I’ve found, in the hopes that it will save everyone a little time that they could be otherwise be using to get 5 more minutes (or 1 extra hug) in with their kids before they head off to school. (*Please note: as with yesterday, I am sourcing other author’s tips and will cite all references below – all copyrights, credit and thanks belong to them)

Heading to School:

Waiting for the Bus:

• Arrive at the stop at least five minutes before the bus arrives and stay out of the street while waiting for the bus to arrive
• Wait on the same side of the street as the school bus loading/unloading zone
• Look before stepping into the street to make sure there are no cars passing the bus
• Cross the street at least 10 feet (or 10 giant steps) in front of the bus to make sure drivers can see them. Drivers have a blind spot of 10 feet in front of the bus.
• Wait until the bus comes to a complete stop before exiting and exit from the front of the bus.
• Ask the bus driver for help if anything is dropped while entering or exiting the bus.

While on the bus:

• Remain seated, forward facing at all times and keep the aisles clear.
• Do not shout or distract the driver unnecessarily – this includes throwing things
• Keep heads and arms inside the bus at all times. Parents should also make sure that they remove loose drawstrings or ties on jackets and sweatshirts that can snag on bus handrails, and replace with Velcro, snaps or buttons.

Walking to school:

• It’s recommended that children under ten never cross the street alone – additionally:
• Choose the safest route and walk it with children.
• Instruct children to recognize and obey all traffic signals and markings.
• Make sure children look in all directions before crossing the street and teach them to never dart out into traffic.
• Direct children to not to enter the street from between parked cars or from behind bushes or shrubs – teach them to cross at a corner or crosswalk.
• Warn children to be extra alert in bad weather
• A bright colored jacket might make your child more visible to traffic.
• In neighborhoods with higher levels of traffic, consider starting a “walking school bus,” in which an adult accompanies a group of neighborhood children walking to school

Riding a bike to school:

• Always wear a bicycle helmet, no matter how short or long the ride.
• Know the “rules of the road”: Ride on the right, in the same direction as auto traffic, use appropriate hand signals and respect traffic lights and stop signs.
• Wear bright color clothing to increase visibility.
• Do not allow children to ride on the road without direct adult supervision until age ten.

Btw – Here’s a great brochure by the National Highway Transportation Safety Administration (NHTSA) that uses graphics and humor to teach little kids how to be safe on their way to school

During the School Day:

Eating during the day:

• Many schools regularly send schedules of cafeteria menus home. This gives you the option of packing lunch on the days when you, or your child, don’t like the meal served.
• Try to get your child’s school to stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice in the vending machines. Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Just one can of soda a day increases a child’s risk of obesity by 60%.

Bullying:

• Today, unfortunately bullying occurs in many different forms and can sometimes be difficult to recognize.  The American Academy of Pediatrics has detailed guidelines on managing bullying from the perspective of the child being bullied, the child who is the bully and the bystander. Across all 3 categories, what is consistent is involving a parent or another adult to develop a proactive solution. Rather than try and abbreviate this section, if this is an issue for your child, well documented and excellent guidelines can be sourced here

Keeping them safe at school:

• Ask your child about safety in his or her school. Where do they feel most safe? Least safe? Why?
• Identify comfort levels and methods for reporting safety concerns. Do students have at least one adult and/or method they would feel comfortable in reporting safety concerns to at school?
• Examine access to your school. Are there a reduced number of doors that can be accessed from the outside (while still allowing children to exit from the inside in an emergency)? Do faculty know who is in their school?
• Determine if your school has a school safety team, safety plan and ongoing process, as well as a school crisis team and school emergency/crisis preparedness guidelines. Are these plans and guidelines reviewed regularly – at least once a year? If so, do the students, school employees and parents know about them? Are they tested and exercised?
• Do school officials have meaningful, working relationships with police, fire and other public safety agencies serving their schools? Do they have direct input on school safety plans?
• Finally 5 excellent questions that your schools crisis mgmt team should know the answer to – if not, get involved (same author):
  1. How do you dial 9-1-1 from the school phones? Do you need to get an outside line first?
  2. What is the actual street address of the school if asked by a 9-1-1 dispatcher?
  3. If your schools nearby walking evacuation site is a community church, does someone have the keys to get in if no one from the church is there when you arrive?
  4. How long does it really take to mobilize your school bus drivers in the middle of the day if you need to evacuate multiple buildings (e.g. half the school +)?
  5. Have you ever trained students NOT to open doors to people on the outside trying to get into the school?

After School:

Getting home safe and staying that way :

• Make sure your child walks home with a group of friends or a responsible adult.
• Make sure to have an adult at the bus stop after school to make sure the kids get home safely.
• Make a code word that will be used when someone else they do not know will pick them up. Every time you have someone pick your child up from school they have to know your secret code word or you child will not get in the vehicle.
• Let them know that if an adult makes them feel uncomfortable or is following them have them call 911 and go back to school, to the police, or to a friend’s home as quick as possible. They need to find a safe place.
• If they are going to be alone in the afternoons, teach them to go straight home, keep doors locked and not answer the door for anyone.
• Finally, remind them never give out personal information to strangers or on the Internet.

So folks, I know it was a long list, but I hope it’s one you’ll find useful. Until next time keep them healthy, keep them safe…and remember we’ll keep doing our best to help you do both, because one ouch is definitely too many

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As we did yesterday, sending out thanks and recognition to some very smart folks for some really terrific advice:

1. Waiting for the Bus, While on the bus, Walking to school and bullet # 4 of Riding a bike to school: (Parents Need to Talk to Children About Safety When Sending Them Back to School, Susan Laurence of Cincinnati Children’s Hospital Medical Center July 24, 2009)
2. Riding a bike to school, Eating during the day, Bullying, and bullet # 8 of Walking to school: (Back to School Tips: American Academy of Pediatrics 2009)
3. Keeping them safe at school: (Parents & School Safety – Can you Prevent Another Tragedy? How Safe is Your Child’s School: by Ken Trump president of National School Safety & Security Svces and 25+ years of school safety experience)
4. Getting home safe and staying that way : (Children’s safety tips to remember for back to school: Melina Ann Collison, St Louis Crime Examiner, July 27, 2009)
5. bullet # 5 of Getting home safe and staying that way : (ADT Safety Tips: Back-to-School Safety, Aug 10, 2009: Patrick Fiel, public safety advisor for ADT Security and former head of security for Washington DC Public Schools)

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“Best of” Back-to-School Health and Safety Tips 2009: Part I

It’s that time of year again…back to school. Some of our kids have already left, some are just heading out…and although we can send them off with a hug, typically there’s a little more we want to do to protect them and make sure there are little to no “ouches” to care for when they arrive home. And our job isn’t easy, because unfortunately the hazards they face – bullying, gangs, drug sales, reckless drivers and predators, just to name a few – can happen before, during or after school. The best we can hope for is to make sure they are healthy before they walk out the door, ensure their trip to and from school is “uneventful”, and equip them with the tools, knowledge and resources to help them keep themselves safe and healthy until they are once again in our care.

To assist our efforts, experts provide us with articles and blog posts of “back to school” health guidelines and safety tips and do’s and don’ts lists, addressing all of these issues in many different forms. In fact there is a wealth of knowledge on the web on how to best prepare your child and send them off to school. Having sourced and searched, and read and compiled, what I would like to do here is save you a little time – which at this time of the year we all know is in incredibly precious – and share with you the best of what I found. (*Please note – I am sourcing other author’s tips and will cite all references below – all copyrights, credit and thanks belong to them)

Before School Begins:

Prep for pre-school physicals:

• Bring your child’s immunization records. If you can’t locate those records, contact your school’s nurse for the most recent copy on file.
• Make a list of any questions you may have regarding your child’s physical, emotional or mental development.
• Encourage your child to be open and forthright with the doctor about any health-related issues
• Don’t wait until the last minute.
• Don’t confuse pre-participation sports physical exams with school physicals. Sports physicals are required in advance of every school year or sports season.

Consider a back-to-school health check list:

• Have your child’s hearing checked.
• Have their vision screened. Young children often don’t know they can’t see well enough for schoolwork
• Be sure immunizations are up to date.
• Investigate possible learning disabilities. If you suspect your child may not be processing information correctly, speak to a teacher or contact a learning center for advice.
• Inventory your child’s mental health. What’s your child’s behavior like? If your child seems anxious or unsteady, talk to your pediatrician or a counselor to help identify the source and a solution
• Plan ahead on prescriptions – especially if medications will need to be given at school
• Scan the scalp.
• Equip the athlete. If your child will participate in sports, be sure that he or she has all the protective equipment needed for the sport.
• Schedule a trip to the dentist. Address any sleep issues.

Conduct a backpack check:

• When fully loaded, your child’s backpack should weigh less than 15 percent of his body weight. To help your child know what this weight feels like, use your bathroom scale to measure the right backpack load.
• Buy a backpack with two wide, padded straps that go over the shoulders — and make sure your child uses both straps at all times.
• Your child’s backpack should not be wider than his body.
• Choose a backpack with a padded waist or chest belt. This distributes weight more evenly across the body. Multiple compartments also help distribute the weight.
• Consider a backpack with a metal frame (like hikers use) or on wheels (like a flight attendant’s bag). Check with your child’s school first to see if these types of bags are allowed.
• Make sure your child isn’t carrying unnecessary items. Laptops, CD players and video games can add a lot of pounds to a backpack.
• Heavier items should be placed closer to the back of the backpack, next to the body.
• Finally teach them to pick up their backpack like any heavy object - bend at the knees to lift.

Deciding when they’re too sick for school:

• As a rule of thumb, a child should stay home if he has a fever higher than 100.4 degrees Fahrenheit OR
• Vomited more than once
• Diarrhea
• A very frequent cough
• Persistent pain (ear, stomach, etc.)
• A widespread rash

For those with “big kids” going off to school, make sure their health is covered:

• Know the plans benefits. Make sure you have read and, in fact, understand the entire contents of the plan brochure.
• What doctors are covered? Can students use their own doctors when at home?
• Does the plan have any authorization or referral requirements?
• How much does it cost? Prices and payment options vary greatly from plan to plan.
• What are the plan exclusions? Often student health plans are considered “accident and sickness plans” meaning they exclude or provide very limited routine and preventative care
• Are there any pre-existing condition limitations? Will your child’s ongoing condition be covered?
• What are the plan maximums? Some student plans are extremely basic and therefore the aggregate benefit maximum may be very low.
• If your child is no longer a student is there an option to extend coverage (i.e. after graduation?)
• What are the deadlines?
• Who is the health insurance carrier?

Check back again soon for Part II where we’ll pick up our “Best of” Back to School – Health and Safety Tips 2009 with suggestions for what to do once they head out the door. Until next time keep them healthy, keep them safe…and remember we’ll keep doing our best to help you do both, because one ouch is definitely too many

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Sending out thanks and recognition to some very smart folks for some really great advice:

1. Prep for pre-school physicals: (School-age physicals: What to know before you go by Drs. Michelle Meeks and Tonja Austin, Aug 4, 2009)
2. Consider a back-to-school health check list: (Kids Need Back-To-School Health Checks by Dr Clay Stallworth July 26, 2009)
3. Conduct a backpack check: (Backpack Safety Tips - Childrens Healthcare of Atlanta by Dr David Marshall Aug 5, 2009)
4. Deciding when they’re too sick for school: (Is Your Child Too Sick for School by Childrens Healthcare of Atlanta Aug 5, 2009)
5. For those with “big kids” going off to school, make sure their health is covered: (10 things you should know when choosing a university sponsored health plan by Manchester Health Insurance Examiner Rachel Arnold July 29, 2009)

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