Trouble swallowing a pill? It's all in the head tilt
The secret to making even the biggest pills slide down tiny throats? Tilting the head, either back, to the side, or down, Calgary researchers have found.
Bonnie Kaplan, of the University of Calgary's Faculty of Medicine and the Alberta Children's Hospital Research Institute for Child and Maternal Health made the discovery while trying to figure out how to help children swallow whole pills.
Seriously ill children often need to take large pills which can't be broken, either because it would alter their effect or would taste terrible.
"If a child with a chronic or acute illness, such as cancer or arthritis, cannot swallow a pill, it can be a huge problem," says Kaplan, a research psychologist, said in a news release.
"Some medications are very difficult to turn into liquid form, or taste horrible when they are liquid."
In some cases, children are ready to leave hospital but can't because they can't swallow pills and have to keep getting their medications through an IV or injections.
So Kaplan and her team set out to find out how to teach kids to swallow them whole.She studied five different positions: staring straight ahead, or looking up, down, to the left or to the right.
She found that pressure in the throat varies depending on which way the head is turned. Depending on the child and the pill, teaching kids to turn their head slightly to the side to swallow can help relieve throat pressure and make it easier to send the pill "down the hatch."
For some kids, swallowing in the usual, looking-straight-ahead way works best. But Kaplan found that was the best position for only about a third of the volunteers who tried all five positions.
"That means maybe only a third of us are swallowing the most comfortable position, even when we're good at swallowing pills," she says.
Kaplan worked with more than 30 children and found that within 14 days, all could be taught to take adult-sized pills easily.
Her method used candies, tiny at first, and then gradually larger, until they were the size of a large adult-sized pill. She taught them tricks to make the pills slide down, including using just a small sip of water, and a "duck shake" of the head to make the pill move back on the tongue before being swallowed.
Ten-year-old Alysa Hauck was one of Kaplan's first subjects. Alysa has to take several medications every day for an autoimmune disorder. Before she could swallow pills, her family had to haul along bottles with liquid drugs in coolers on every outing. That made travel and playing with other kids difficult.
That all changed when she took part in Kaplan's study.
"It was so empowering for her to be able to swallow pills. It opened so many doors. We can take trips now, she can go to the park for the afternoon, she is invited to sleepover, just like any normal girl," says mom Fabiola of Alysa, now 10 years old.
Alysa can now visit with friends whenever she wants, and has even taught both her brother and mother to swallow medication more easily, using Tic Tac candies, just as she was shown during the study.
Kaplan says learning to swallow a pill might sound like a small accomplishment, but it can make a huge difference in people's lives.
"It is a simple intervention that has broad implications for the lay public, like the Heimlich manoeuvre." says Kaplan.
The Alberta Children's Hospital Foundation has now loaded videos on to its website showing techniques for learning and teaching how to swallow pills.
Kaplan's study is published in the journal, Paediatrics & Child Health.