Parents are good at lots of things, but giving our children the right dose of medicine is not one of them. That's not entirely our fault: The measuring cups and droppers that come with popular liquid children's remedies like pain relievers, allergy medicine, and tummy aids are so poorly marked and inconsistent with package labeling that they may be dangerous, according to a new study in the Journal of the American Medical Association.
This is not a new problem; there's research aplenty showing that parents make errors 40 to 60 percent of the time when giving their children medicine. Add in the fact that we're often doing it at 4 a.m. at the bedside of a crying child, and it's no wonder the measuring process can be haphazard at best. That's all the more reason that the tools we use to medicate our children should be as foolproof as possible. But they're far from that.
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The JAMA report found that 98.6 percent of 200 top-selling children's liquid medicines tested had inconsistencies between the directions on the package and the markings on the cup or syringe included. Almost 25 percent of the products lacked the markings needed to properly measure medicine, and 81 percent of the cups or syringes had markings that weren't among the label's recommended doses.
Children's medicine manufacturers could solve some of these problems by enclosing a standard measuring device with all medicines—half of all tummy medicines don't come with a cup or syringe, as recommended by the Food and Drug Administration. The JAMA authors also say the measurements on the label and the measuring device need to agree. But that's just a start to solving the problem. The authors of the JAMA paper also recommend that all manufacturers use the same measuring units and abbreviations, such as milliliters, rather than teaspoons and tablespoons. That will take industry, and probably government, intervention.
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In the meantime, we've got kids to take care of. Darren DeWalt, an assistant professor of medicine at the University of North Carolina School of Medicine, spoke with U.S. News about what parents can do to protect their children from dosing errors while the industry gets its act together. DeWalt studies how well people understand medical information and wrote an editorial in JAMA calling for not just better packaging, but more help for parents. Here's his advice:
- Don't grab a spoon from the silverware drawer for dosing medicine. "We know those are inaccurate," DeWalt says. But parents often choose them because those plastic cups that come with many children's medications are "unintelligible," he says.
- If you're using medicine that comes with a cup or a syringe, take it to the pharmacist and ask her to put a mark on it. Say: "My kid weighs 40 pounds. Can you mark the right dosage?" DeWalt says that's the easiest way to reduce the risk of mistakes that can lead to dangerous drug overdoses.
- Realize that doling out the correct dose is difficult in the best of circumstances, and give extra attention to the process if you're up in the middle of the night with a sick child. Says DeWalt: "One thing we know for sure is that it's easy to make mistakes."
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Other research has found that droppers are more accurate than are the oft-provided plastic measuring cups, but the FDA has been urging parents to use the measuring devices packaged with the medicine, even if they aren't droppers. Confusing enough? Once again, more clarity and guidance is desperately needed.
The bottom line: We parents need to come up with a system for our families that will be as accurate as possible, given the crummy tools we've got to work with. You can be sure that the next time I buy over-the-counter meds for my child, I'll march right up to the pharmacist's counter, Sharpie in hand, and say: "Can you mark this for me?"
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