Ask the Expert!

by Dawn Winkelmann, M.S., CCC-SLP

Hello, my name is Dawn Winkelmann, M.S, CCC-SLP and I am a Speech Language Pathologist and Feeding Therapist here to answer any questions you may have regarding pill swallowing and the swallowing process.

I heard that if you tilt your head back when you swallow pills you could choke. Why does everyone seem to teach children to do this though?

A: This is an interesting question and one I have thought about many times myself. I lecture nationally about safe pill swallowing to parents and they always seem so shocked to know that tilting your head back to swallow pills opens your airway. Pills are not meant to go into the airway but into the stomach. However, there are so many pediatric cases of aspiration of pills, tablets, liquids, foods and even vomit. To ensure a safe and functional swallow, your chin should be in flexion (slightly tucked) to protect your vocal folds, your lungs and to decrease choking. The good news is you can do this safely using the Oralflo cup!

Do problems like swallowing pills and certain foods persist into adulthood? I ask this because I worry that my son will never grow out of his fear of swallowing. Is this fear real?
A: Yes, problems with swallowing can continue into adulthood. It amazes me how many adults contact me and state that they have been a picky eater since they were a child and now they finally want to work on it. To answer your other question, your son may have what is called phagophobia, which is a fear of swallowing. This is a true disorder. This fear can occur when children are forced to take medicine or food or when a child has suffered a traumatic event while they were swallowing. My recommendation is to seek out a Speech and Language Pathologist who specializes in Feeding and Swallowing Disorders.

My husband always complains that when he takes pills it feels like there is a ping- pong ball stuck in his throat. He eats fine so why would he say this?
A: The feeling of having something stuck in his throat could be a spasm in the cricopharyngeus muscle (the upper esophageal sphincter). This cricopharyngeal spasm, is a common disorder that generally resolves on it’s own. Usually, the client can swallow food just fine, but swallowing their own saliva or swallowing pills aggravates the symptoms resulting in a more intense spasm. Clinically I have only seen this to be stress related, so reducing stress is warranted as well as drinking warm fluids like miso soup or hot non-caffeinated tea to help ease the symptoms. At times, some of my clients have used medications prescribed by their Ear Nose and Throat physician (ENT) to help relax the muscles. If severe, there are surgical options as well. Seek out an ENT specializing in cricopharyngeal spasms to have a full assessment.

I have a 3-and-a-half-year-old son with Autism that takes 16 pills a day, which is a
battleground for me. Can he use the Oralflo cup?

A: I can relate to your situation as I specialize in pill swallowing with children on the Autistic Spectrum. So, I know that you are looking for a product that will help you and your son maintain a healthy trust relationship and still get the medication he so desperately needs. However, Oralflo Technologies states that their product is recommended from age 4 years to adult. After stating that fact, I also have to tell you that I work with several parents with children under the age of 4 who have bought and used the cup successfully without any difficulties.

My son’s ABA therapist said he should take his pills from a regular cup and that his refusal is just a behavior. Should I even try the Oralflo cup? I don’t want to purchase anything my son behaviorally shouldn’t use.
A: I can see your therapist’s concern. However from my clinical experience 80% of the time this form of refusal is not a behavior. There is usually underlying swallowing, feeding or sensory issue. Speech Language Pathologists and Occupational Therapists are the medically trained professionals licensed to assist individuals in swallowing & feeding disorders and sensory issues. My suggestion is to seek the services of one of these qualified therapists. Chances are your son may have a feeding or sensory issue with the pills in his mouth and the Oralflo pill-swallowing cup could be the answer to his deep-rooted sensory needs.

My daughter (age 7) and I are always stressed out when it is time for her to take her medication. Every morning, she refuses to take her pills and I have to force her to take them. We both leave the house for school feeling frustrated. How can I be assured she is taking her seizure medication but still allow her to be more independent?
A: There is good news! The Oralflo pill-swallowing cup is designed in such a way that a child can feel like they have control of the pills. Most of my clients state that they feel empowered by this independence and their pill anxiety and refusal decreases. As a parent, you can look into the pill spout to see if her pill was swallowed and take comfort in the knowledge that she is medically safe.

I am an adult who has a hyper gag reflex. I gag on my toothbrush, I gag when I’m eating and I especially gag when I take pills. Can the Oralflo cup work for me?
A: Yes it can! Gagging is a natural reflex we have to protect us from choking, but we all have different levels of sensitivity with this reflex. What I like about the design of the Oralflo cup for clients with a strong gag reflex is that you have to make a strong lip seal around the cup. This muscular process alone will decrease the gag reflex as the trigger of a gag is usually when the texture of the pill hits your soft palate. Having your lips and tongue be in an anterior position to swallow water decreases the anatomical gag-inducing activity. In addition, pill anxiety occurs when you ‘think’ the pill is going to get stuck in your throat. With the Oralflo cup the pill is immersed in water allowing your throat muscles and cranial nerves to focus on relaxing and contracting in order to swallow the water (and pill) safely.Order Oralflo - The Pill Swallowing Cup

**The information contained in this site and associated services is offered in good faith and represents only the author’s current understanding of best practices in speech, language, swallowing and feeding therapies.
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Awards - Oralflo - The Pill Swallowing Cup

2014 Oralflo Technologies