Medications for children: Getting the dose right

Photo of a man with a child who has a fever
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When children are ill, parents can help them get through it by calming, consoling and distracting them. They may have to give the child medication too. 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 treatment with medication 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, or you might forget to give the medicine.

How can parents avoid mistakes when giving children medication?

There is a tendency for parents to give young children too much medicine – mainly because they don't take into account how little the child weighs. Also, the marks on dispensers may be confusing, or the information found on package inserts may not be easy to understand in a hurry. Children are especially likely to get too much medicine if it's given in the form of a liquid, such as liquid , painkillers or cough syrup. Doses that are too high can have serious health consequences. But there are a few things parents can do to avoid making mistakes 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. It is safer to weigh them using bathroom scales rather than estimating their weight.
  • How the medication is to be used: Follow the instructions on how to use the medication – for example, make sure the child swallows tablets with enough water and check whether the medicine 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 and 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. It can be helpful to measure liquid medicines using disposable syringes instead – especially when giving medication to young babies. These syringes are available from pharmacies.
  • Lighting: Make sure there's enough light when measuring the dose of medication – particularly at night – to make sure you can see properly and get it right.
  • Reminders: Make a note whenever you give the child a dose, for instance on a slip of paper or a sticker on the bottle of medicine. 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: It is also important to carefully read the instructions for any medication that you get without a prescription. 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 if the child is taking other medicine at the same time.
  • Original packaging: Do not pour drop solutions into another bottle or dilute them. Doing this could change the size of the drop, which affects the dose.
  • Advice following dosing errors: In the event of an accidental overdose, contact a doctor or pharmacist as soon as possible and get advice on what should be done. If one of the doses was forgotten, the child vomited after taking the medication or spat out some of it, don't give a double dose the next time to "even things out." Instead, follow the usual schedule, but also seek advice.

Some tablets and capsules should not be crushed or broken into smaller pieces, and mixing them with food can also cause problems. If you're not sure about any of these things or have other questions, it's 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. 2006.

Moreno MA. Medication Safety for Children. Arch Pediatr Adolesc Med 2010; 164(2): 208.

U.S. Food and Drug Administration (FDA). Ten Tips to Prevent an Accidental Overdose. 2011.

Yin HS, Wolf MS, Dreyer BP et al. Evaluation of consistency in dosing directions and measuring devices for pediatric nonprescription liquid medications. JAMA 2010; 304(23): 2595-2602.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on August 24, 2021
Next planned update: 2024

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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