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Posted by Dr. Monica Wonnacott | September 19, 2016

How To Reduce Medication Mistakes

I don’t give my children medication very often. In general, I think medications are over prescribed and kids are often over medicated. Ironically enough, two of my children ended up getting medication tonight before bed. My oldest got an over-the-counter medication where I just used the measuring/dosing cup that came with the product. My baby, got an antibiotic that I used a syringe to dose.

After putting them to bed, I pulled out my copy of the September 2016 Pediatrics journal. Wouldn’t you know it, there’s an article about medication dosing errors: “Liquid Medication Errors and Dosing Tools: A Randomized Controlled Experiment.” Naturally, I was intrigued. In short, we’re all blowing it when it comes to giving medication to our kids.

The study found that 84.4% of parents made one or more dosing errors (as defined by being off by 20% or more) when giving medications. (Parents were measured giving 9 different doses). I was blown away; almost everyone made mistakes. Furthermore, more errors were made with cups than syringes.

Over time, lots have studies have shown how bad it is to use kitchen spoons, teaspoons, and such to measure and give liquid medications. They are all different sizes, so it makes sense that many dosing errors would happen using those methods. I just never imagined so many mistakes would happen with the devices designed to measure medications.

So how do I get the most accurate measurements?

  1. Use a syringe to measure. Use the smallest syringe possible for the amount of medication needed (e.g., if the medication dose is 0.7 mL, use a 1 mL syringe rather than a 10 mL syringe). The closer the medication dose to the syringe size, the more precisely it can be measured.
  2. Choose a syringe that has markings for individual numbers (e.g., 1 mL, 2mL, 3 mL, etc., through 10 mL instead of 5 mL, and 10 mL only).
  3. When drawing up the medication, make sure the syringe is completely depressed and the end is completely covered with the liquid before drawing up the syringe. Draw up more than needed and then push out the excess back into the bottle “down to the desired dose.” This will ensure air bubbles are not drawn up in the dose.
  4. If the medication arcs slightly in the syringe (where the liquid comes up slightly on the sides), use the bottom of the arc to line up the measurement.
  5. Avoid spoons, cups, teaspoons, etc.


Doctors should write liquid prescriptions in “mL” (milliliter) doses. However, sometimes doctors inadvertently write them in teaspoons (a bad, old habit). In case they do, it’s worth knowing what doses are equal.

  1. 5 mL = 1 teaspoon (tsp)
  2. 3 teaspoon (tsp) = 1 tablespoon (tbsp)
  3. 1 tablespoon = 15 mL

I hope this helps you dose liquid medications more accurately to your little ones. I know I’m going to ditch the medicine cups that come with the medications and stick with syringes.