Milliliters May Inch out Spoonfuls as Safest Measure of Children’s Medication

Thursday, July 17, 2014
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Americans have never been big on the metric system, but medical experts and others say it is time to start using some elements of the measuring system when it comes to children’s medications.


Most medicines sold in the United States come with dosing instructions that call for teaspoon- or tablespoon-sized amounts. The problem with this method, a new study shows, is it can lead to overdosing and potentially dangerous outcomes for children.


Approximately 10,000 people each year contact poison control centers because of confusion about medicine directions, according to the American Association of Poison Control Centers. That’s why some professional organizations are now advocating for American liquid medicines to be dispensed in milliliters.


The new study published in the journal Pediatrics says using milliliters is much safer and produces fewer risks of overdosing kids.


After talking to more than 280 parents, researchers led by Dr. H. Shonna Yin of New York University School of Medicine found parents who relied on teaspoons and tablespoons were nearly twice as likely to make mistakes as those who measured in milliliters.


“A kitchen spoon is less precise,” Dr. Ian M. Paul, a professor of pediatrics at Penn State University College of Medicine who participated in the study, told The New York Times.  “There are no markings on it, and they vary widely in size. You could way overdose.”

The American Academy of Pediatrics has recommended that doctors prescribe in milliliters in electronic medical records. Also, the National Council for Prescription Drug Programs has told pharmacies to utilize milliliters on prescription container labels and urges that a dosing device, such as a cup or syringe with appropriate measurement markings, be included with each liquid prescription.

Even some members of the drug industry are starting to get on board. The Consumer Healthcare Products Association, which represents over-the-counter drug sellers, is developing guidelines for instructions that use milliliters only.

-Noel Brinkerhoff


To Learn More:

A Spoonful of Medicine May Put Children at Risk (by Jan Hoffman, New York Times)

Unit of Measurement Used and Parent Medication Dosing Errors (by H. Shonna Yin, Benard P. Dreyer, Donna C. Ugboaja, Dayana C. Sanchez, Ian M. Paul, Hannah A. Moreira, Luis Rodriguez, and Alan L. Mendelsohn; Pediatrics)

NCPDP Recommendations and Guidance for Standardizing the Dosing Designations on Prescription Container Labels of Oral Liquid Medications (National Council for Prescription Drug Programs) (pdf)


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