The times when you find yourself doling out medicine for your kid are generally not the most clear-headed moments. You might have listened to hours of coughing or crying, and chances are you're running on next to no sleep. Then you attempt to calculate how much medicine they need for their weight using a simple formula that, at 3 a.m., feels like a grade 12 calculus equation. Add in the confusing labels and measuring tools, and many parents end up giving their kids the wrong dose. But researchers have identified a few things drug manufacturers can do to make it easier on you.
A new US study published in Pediatrics found that parents would make fewer errors if they used measuring cups or syringes in sizes that more closely matched the dose, if they were shown pictograms of the dose on the label and if they were given instructions and tools that used only millilitres—not teaspoons.
The study, which involved almost 500 parents of kids ages eight and under, asked parents to measure out three different doses three times, using a different measuring tool each time (a cup, a small syringe and a large syringe). Some parents received text-only instructions, while others got pictures; and some were given the doses in both millimetres and teaspoons. More than 80 percent of parents made at least one error in the nine doses, and 30 percent of parents doubled at least one dose.
Parents were least likely to make mistakes when the label and the measuring tool only listed one unit (millilitres), when they saw pictures of the dose and when they used measuring devices that were closer in size to the dose they were giving.
When parents used tools that were much bigger than the dose—say, a 10 mL syringe for a 2 mL dose—they were more likely to overdose their children. Using a dosing tool that’s too small—say, a 5 mL syringe for an 7.5 mL dose—also led to medication errors, because splitting the dose into two parts meant doing more math.
Previous recommendations from the American Academy of Pediatrics have suggested avoiding teaspoons as a measurement unit, because when parents see the word "teaspoon," they're more likely to reach for a kitchen spoon which can lead to an overdose.
Now, with these new findings, Shonna Yin, lead author of the study and a doctor in the department of paediatrics at New York University School of Medicine, says there is good reason for drug manufacturers to include pictures with their dosing instructions. But including the correct dosing tool in the box is a bit more complicated. “In terms of over-the-counter products, the problem is there are multiple doses depending on the age of the child, and oftentimes there’s just one tool in the box,” she says. She proposes that one solution may be for drug companies to market meds specifically to infants, toddlers or bigger kids, and include separate measuring tools that reflect the proper dosage for each.
But parents don't have to wait around for drug companies to make these improvements; you can buy your own medicine syringe that is sized for your child’s dose, or ask your pharmacist for the best tool to use and for clarification on measuring the right dose. Yin adds that parents can also ask their health care provider to draw a picture of the dose if they don’t understand the text instructions on the label, which can be confusing, particularly for those with literacy struggles.
Getting the right dose is important for kids’ health. “With overdosing you worry about drug toxicity and side effects,” says Yin. “But even with underdosing, we are concerned that means the child’s illness is not being properly treated.”
We all want kids to get better faster, and if using a new measuring tool will do the trick, it's totally worth it.