Too Much, Too Little, Just Right? How To Know If You’re Giving Your Child The Right Dose

Here at Westchester Health Pediatrics, a common issue that we see is parents not knowing the correct dose of medicine to give their child, particularly with over-the-counter medications.

They often don’t know the difference between measurements in teaspoons, mL’s or cc’s, and may not want to admit that they don’t understand. Or if it is 2am, they may not want to disturb their pediatrician to ask. In those cases, they may just guess on a dose and either under- or overdose their child. This could cause serious problems, especially in very young children.

Cindee J. Ivker, MD, FAAP

Many parents do not understand the ingredients in over-the-counter medications, especially with older children and cold and cough medicines.

These means that they often end up giving more than one medicine with the same ingredients. This can result in an overdose, or side effects that mimic the illness itself, such as sleepiness or lethargy, making it hard to tell what’s really going on with the child.

Another issue is that some medications, like Advil, have both children’s and infants’ formulations which have different concentrations.

If a parent gives an infant the children’s dose of an infant formulation, that would be double the amount they need. Unfortunately, this is a common problem. A 2018 survey by the Consumer Healthcare Products Association Educational Foundation of 1,400 parents of children ages 4 to 6 found that nearly 1 in 4 parents surveyed did not believe OTC medication was strong enough to require precise dosing. (It is.) And 1 in 5 parents said they believe that using a household spoon is okay for measuring medicines. (It’s not.)

To avoid giving too much, too little, or the wrong medicine, follow these 9 important tips

To help parents better understand what medication dosages to give their children, here are some important guidelines, compiled from Westchester Health Pediatrics pediatricians as well as from a recent article in The New York Times:

  1. The physician needs to give clear instructions

In my practice, I try to use the “repeat back” method. After I give clear instructions, I ask the parent (or patient, if he/she is old enough) to repeat what I said so that I am sure they understand.

  1. Do not use kitchen spoons

Household spoons should not be used for giving medicine. They have different shapes and sizes and are not an accurate dosing device. You should always use the dosing device that comes with the medicine. (We recommend a syringe.)

  1. Always read the label

Dosing instructions are often based on age and weight. If these differ, follow the weight recommendation. It’s more accurate.

  1. Store medication where a child can’t reach it

Even if you’re tempted to leave out medicine on a counter or sink so it’s easy to access in the middle of the night, don’t. This could have serious consequences.

  1. Don’t mix medicines

If you’re giving your child two different medicines at once, carefully read the ingredient list on each label to make sure you’re not accidentally giving double the dose. You should never give more than one medicine that includes the same active ingredient. For example, acetaminophen (Tylenol) is often given to relieve pain and reduce fever but it is also an ingredient in combination medications to control a range of cold symptoms.

  1. Make sure your child is old enough to be getting OTC medicine

The American Academy of Pediatrics actively discourages the use of over-the-counter cold medicine in children under age 4.

  1. Ask for a syringe

If medicine does not come with a syringe, ask your pharmacist for one. A syringe is more accurate than a plastic dosing cup (or a spoon) and should be used whenever possible, even though cups are more often included with OTC medicines. According to a recent government study, the odds of getting the dose wrong are 4 times greater with a cup.

  1. We do not recommend cough syrup for children

According to a 2012 report in the journal Lung, no OTC cough syrups have been shown to effectively suppress cough. Furthermore, medicines containing codeine or other opiates can have serious side effects, which is why the Food and Drug Administration discourages their use in children and teens. For children with a cough who are at least 12 months old, we at Westchester Health Pediatrics recommend a spoonful of honey.

  1. Ask your doctor how much to give a child under 2

The most common medication given to children age 2 and under is acetaminophen (Tylenol) to relieve fever and pain for children over 3 months of age. However, there is not a specific dose indicated on the label for children under 2 years old. Before giving Tylenol to a child under 2, check with your pediatrician or healthcare provider.

If you’ve overdosed your child

If you think you may have accidentally overdosed your child, contact your healthcare provider immediately or call your local Poison Control Center. There are 55 poison control centers across the U.S. and all can be reached by calling the same hotline number: 1-800-222-1222. A medical professional will answer the call and can help you quickly figure out how much medicine the child got over what time period, whether that was too much and what to do next.

Helpful articles we recommend:

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You’ve got questions, we’ve got answers. Whether you’re raising teenagers, adolescents, toddlers or newborns, we’ve got years and years of experience helping parents take care of their children and we’re ready to help you with yours.

Got questions about correct medicine dosing? Come see us.

If you’re concerned or have questions about the correct amount of medicine to give your child, come in and talk with one of our Westchester Health Pediatrics pediatricians. We’ll go over all the different variables and give you our recommendations for safe, correct dosages. Our #1 goal is to help you raise a happy, healthy child and for you to feel confident as a parent. Whenever, wherever you need us, we’re here for you.Make an appt

By Cindee J. Ivker, MD, FAAP, Lead Pediatric Physician with Westchester Health Pediatrics, member of Northwell Health Physician Partners

by WHA-Admin