How do you instruct a child to take a chewable tablet?

How to Instruct a Child to Take a Chewable Tablet

Direct Instruction Method

Instruct the child to place the chewable tablet in their mouth and chew it completely before swallowing, similar to chewing food, and explain that the tablet is designed to be chewed rather than swallowed whole. 1, 2

Age-Appropriate Guidance

Children 2 Years and Older

• Chewable tablets are safe and appropriate for children 2 years of age and older, offering advantages including palatability, stability, precise dosing, and ease of delivery 2
• Explain to the child in simple terms that the tablet is like a "medicine candy" that needs to be chewed up completely 2
• Some formulations come in flavored varieties (such as strawberry-flavored tablets) which improve acceptability 1

Younger Children (Under 6 Years)

• For children who resist taking medication, consider mixing the contents with soft foods if the formulation allows 3
• Use distraction techniques during administration: play with the child, have favorite toys available, or engage in activities like blowing bubbles, coloring, or reading together 1
• Remain calm to model self-regulation and avoid creating negative associations with medication 1

Step-by-Step Administration Protocol

1. Ensure the child is sitting upright to prevent choking risk 2

2. Show the child the tablet and explain it needs to be chewed, not swallowed whole 2

3. Place the tablet in the child's mouth on the tongue or between the cheek and gum 2

4. Instruct the child to chew thoroughly until the tablet is completely broken down 1, 2

5. Have water or preferred beverage available to help wash down any remaining particles after chewing 1

6. Offer positive reinforcement immediately after successful administration, using specific praise for the behavior 1

Common Pitfalls and Solutions

Refusal to Take Medication

• The most common reason for non-administration is the child's refusal, often due to bad taste 1
• Address this by:
  • Offering a preferred drink immediately after chewing 1
  • Providing a small food reward like popsicles, pudding, yogurt, or ice cream after medication 1
  • Using positive language: "We chew our medicine to help us feel better" rather than commands 1

Difficulty Chewing

• Chewable tablets are designed to break down easily in the mouth, with hardness and thickness optimized for pediatric use 4
• Brief exposure to saliva (30 seconds) significantly reduces the hardness of chewable tablets, making them easier to chew 4
• If the child struggles, encourage them to let the tablet sit in their mouth briefly before chewing 4

Swallowing Whole Instead of Chewing

• Emphasize that this specific medication must be chewed, as the formulation is designed for chewing 2
• Demonstrate the chewing motion yourself or have an older sibling model the behavior 1
• Note that while 91% of children ages 6-11 can swallow regular tablets, chewable formulations are specifically designed to be chewed for proper drug delivery 5

Safety Considerations

• Foreign-body injuries and aspiration events related to chewable tablets are extremely rare in the published literature 2
• Always supervise young children during medication administration 2
• Ensure the child is fully awake and alert before giving medication 2
• Store chewable tablets safely out of reach, as their candy-like appearance may attract children 1

Monitoring Compliance

• Ask the child directly if they chewed and swallowed the medication rather than assuming compliance 1
• For ongoing therapy, establish a regular schedule and routine to normalize the process 1
• Use age-appropriate pain or symptom scales to assess whether the medication is working, which reinforces the importance of taking it correctly 1