Kids’ Medications: Get The Dosage Right


Many parents are making mistakes when giving medicine to their children, according to a new study. Experts recommend using an oral syringe instead of a cup or spoon to prevent many of these errors.

“When parents used dosing cups, they had four times the odds of making a dosing error, compared to when they used an oral syringe,” said Dr. Shonna Yin, an associate professor at NYU Medical School and a co-author of the study, published today in the journal Pediatrics

Medicines made for children tend to come in liquid formulations, making accurate dosing more problematical – especially for a worried parent. And, according to the study, the problem is compounded because packaging, labeling and dosing information are not standardized.

Sometimes dose information is given according to the child’s weight, and a parent or caretaker may not know the child’s exact weight. Other times abbreviations for teaspoons and tablespoons are used, which can be confusing, especially late at night when a parent may be especially tired after being up with a sick child. The worst: When the package information specifies teaspoons/tablespoons but the provided medicine cup shows milliliters.

Dosing information is especially confusing for parents who aren’t fluent in English, when dosing info is provided only in English. Parents with low literacy skills struggle to determine the right dose. Even parents who are literate have problems determining a dose based on instructions they previously received from a doctor or pharmacist when a child was younger or weighed less,.

Dosage Error Statistics

The experiments for the study were conducted at pediatric outpatient clinics in Atlanta, New York, and Stanford, California. 2,110 caregivers of children 8 years old or younger participated in the experiments, 77% had either “low” or “marginal” health literacy abilities.

The researchers measured health literacy by showing study participants a nutrition label and assessing the participants’ ability to correctly read the text, extract key information from a table, and perform basic math that would enable participants to make correct dosing decisions.

Participants were then given labels and asked to measure nine doses of medication using instructions on the label with various tools like medicine cups, spoons and oral syringes. 84.4% of caregivers made one or more dosing errors. More errors were seen with cups than syringes, especially when it came to smaller doses.

The most common mistake was overdosing: 68% of the study participants poured out too much, rather than too little medicine. And 21% poured out twice the recommended dose of the medication.

Dr. Stan Spinner, Texas Children’s Pediatrics’ chief medical officer, said that the most common side effects in cases of overdose include “irritability, abdominal pain, agitation, nausea, vomiting, rapid heart rate and increased blood pressure.”

The most serious side effects — increased heart rate and blood pressure – “might present only as fussiness in toddlers or infants, and parents might not understand what’s happening.”

Preventing Accidental Overdoses

The most important takeaway from the study is that you’re much less likely to make a mistake when you use an oral syringe. People who used the medication cups that come with liiquid meds were four times more likely to make a mistake than if they used a syringe. The mistakes were more likely when the dose was small, but the cups can be confusing no matter what the dose.

Using spoons – the kind you eat with – isn’t a good idea either. Eating utensils aren’t created with precise measurements in mind, they come in a wide variety of sizes and even a tiny variance can lead to overdosing. Measuring spoons are a better choice, but since measuring spoons aren’t designed to fit into little mouths you’ll probably have to measure the amount and then transfer it to a cup or spoon. This can result in your child not getting the correct dose of medication.

Medication syringes are the right tool for the task. You can measure dosages exactly, and be sure that all of the medication gets into your child’s mouth. Ask your pharmacist for a syringe whenever your child is prescribed a liquid medication, or purchase a few to use with over-the-counter liquid medicines.

Read the instructions carefully, and ask the pharmacist or your doctor about anything you don’t understand. If you don’t have access to the pharmacist or your doctor, consider using a telemedicine service like Teledoc or Nurseline. Health insurance sometimes covers part of the cost of these services, or you can join a telemedicine plan and get free consultations with doctors, nurses, pharmacists and other healthcare professionals.

For more information about telemedicine plans, visit


Join. Save. Smile.