A recent study in Pediatrics reported a surprising fact: 20% of parents who gave their kids liquid medicine gave their children more than twice the right dose. In the same study, nearly all the parents made dosing errors of some kind.
Researchers found that packaging changes could help. Medications that came with an oral syringe and gave measurements in milliliters were less likely to be involved in dosing errors than those that had a dosing cup or gave the measurements in teaspoons. 43% of parents made mistakes with the cup, compared to 16% using a syringe.
A syringe marked with milliliters and teaspoons was confusing, too, when the bottle was labeled with teaspoons. A mismatch between what’s marked on the package and the tool provided caused higher levels of error.
Why does the packaging matter?
We’re guessing here, but we can see a couple of possible reasons for the difference in dosing errors with medicines that had syringes versus those that used household measures or cups.
First, syringes are less common, and most Americans are not as familiar with milliliters — or any metric measurements. Therefore, the parents using these unfamiliar measuring tools were more likely to slow down and pay attention.
If you’re giving your child a teaspoonful of medicine, you might be influenced by cooking. Chances are good that you don’t measure that teaspoonful of vanilla extract or Worcestershire sauce very precisely. You might even use a spoon from your flatware drawer instead of a measuring spoon — or just eyeball it as you pour from the bottle.
This casual feeling toward spoons and cups could easily influence busy parents.
However, for a infant, an extra teaspoonful of some medicines can be way too much. A parent giving a baby four doses of medicine a day for a week racks up 28 total doses. If all of them are a little off in one direction or the other and 5 or 6 (20%) are twice the correct dose, that’s a lot of error.
Of course, 20% of the parents in the trials pouring out double the dosage doesn’t mean that each parent made those errors 20% of the time. There were 2110 caregivers in the study and each was asked to measure out a total of 9 doses. 84.4% of the parents made mistakes, and 1 in 5 of all the doses was at least double the right amount.
What’s the solution?
The researchers in this study were figuring out how packaging can help with the common problem of dosing errors. They have some useful data for the manufacturers of these medicines now. But it’s alarming that nearly 85% of parents made errors.
In your own home, when you may be giving medicine with one hand and talking on the phone with the other, the frequency of errors might be even higher.
How can you be one of the 15% who give accurate doses?
Ask for an oral syringe for liquid medications or buy your own. Most pharmacies provide the oral syringe for pediatric medications.
Our pediatricians recommend the oral syringe for accuracy instead of a pediatric dosing spoon or cup provided with some medications.
Mark the right level with a Sharpie on the syringe so it will be easier to see.
- Hold the cup or syringe at eye level and be sure it’s flat.
- Pay close attention when measuring.
- Don’t use household utensils like cereal spoons to measure.
- Sometimes the dosing instructions on the bottle and measuring device are not consistent. Make sure you are using the correct conversions or ask your pediatrician or pharmacist.
- 5 Milliliters (mL) = 1 Teaspoon (tsp)
- 7.5 mL = 1 1/2 tsp
- 10 mL = 2 tsp
If you are unsure about how much medicine to give your child, check with your pediatrician or pharmacist.
Speak up, too, when you have a chance. Let your friends know that this is an issue. Tweet to the manufacturers of the next medicine you receive with a dosing cup or confusing instructions.