Children and medications: Getting the dose right
Calm, console and distract: When a child is ill, parents have their hands full. They have to help their child get through a difficult phase, and may also have to give him or her medication. That is not always easy.
In children, many illnesses will go away on their own after a while and don't need to be treated with medication. So it may be worthwhile considering whether drug treatment is really necessary, and if the pros outweigh the cons.
For medication to work properly, it's important that it's taken as recommended. This can sometimes be difficult, especially if you are dealing with younger children. They might keep their mouth tightly shut, spit tablets out again, or protest loudly against taking any medicine. This can be stressful – for both the parents and the child. If you're stressed, mistakes are more likely to happen when measuring a dose of medicine, and doses are more likely to be forgotten.
How can parents avoid mistakes when giving children medication?
There is a tendency for parents to give young children too much medicine. The reason for this is their low body weight. Also, the marks on dispensers may be confusing, or the information found on package inserts may not be easy to understand. Children are especially likely to get too much medicine if it's given in the form of a liquid, such as liquid antibiotics, painkillers or cough syrup. This can have serious health consequences. But there are a few things parents can do to prevent mistakes from happening when giving children medication:
- Package insert: Carefully read through the package insert and follow the recommendations.
- The correct dosage: Pay special care to how much medicine you have to give, and check the amount three times to be sure before you give the first dose: It must be suitable for the child’s age and weight. Placing children on a scale is safer than estimating their weight.
- When it is to be used: Follow the instructions on how to use the medication – for example, use enough water when the child swallows a tablet and check whether it needs to be taken before, with or after a meal.
- Dispensers: Any dispensers that are included in the packaging should be used. Droppers, dosing caps or measuring cups are the most commonly included types of dispensers. Dispensers are only suitable for the medication that they came with, not for any others. If the dosing instructions specify a "spoonful," check whether they mean a teaspoon or a tablespoon. The size of these spoons can vary a lot, though. The standard measurement is usually 5 ml for a teaspoon, and 15 ml for a tablespoon. Instead use disposable syringes available from the pharmacy to measure liquid medicines – this can be especially helpful when giving medication to infants.
- Lighting: Make sure there is enough light when measuring the dose of medication, and always turn on a light when doing this at night.
- Reminders: Put a sticker or slip of paper on the bottle of medicine and make a note whenever you give the child a dose. This is especially important if the medicine is needed several times a day and specific times need to be followed, or if the medicine is given to the child by different people at different times.
- Over-the-counter medication: Also carefully read the instructions for medication that can be bought over the counter. If you aren't sure about whether the medication is suitable for children, seek advice from a doctor or ask at the pharmacy. This is especially important if no dose recommendations can be found for the weight or age of the child or the child is taking other medicine at the same time.
- Original packaging: Do not pour drop solution into another bottle or dilute them. Doing this could change the size of the drop, which affects the dose.
- Seek advice for dosing errors: In the event of accidental overdose, contact a doctor or pharmacist and get advice on what should be done. If one of the doses was forgotten, the child vomited after taking the medication or spit out part of it, don't give a double dose the next time just to "even things out." Instead, follow the usual schedule, but also seek advice.
Some medications may not be crushed or broken into smaller pieces, and mixing them with food can also cause problems.
If you feel unsure about any of these things or have other questions, it is a good idea to consult a doctor or pharmacist.
European Medicines Agency (EMA), Committee for medicinal products for human use (CHMP). Reflection Paper: Formulations of choice for the paediatric population. July 28, 2006.
Moreno MA. Medication Safety for Children. Arch Pediatr Adolesc Med 2010; 164(2): 208.
US Food and Drug Administration (FDA). Antibiotics and Antibiotic Resistance. September 18, 2014.
Yin HS, Wolf MS, Dreyer BP, Sanders LM, Parker RM. Evaluation of consistency in dosing directions and measuring devices for pediatric nonprescription liquid medications. JAMA 2010; 304(23): 2595-2602.
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