It’s that time of year again. The season of snot and mucus and colds….if you’re a parent you may even call this “sick season.” Typical cold viruses are getting readily exchanged as recirculated air in crowded malls, classrooms and daycares facilitate exchange of the germs. It’s more than inevitable that one of your kids will come down with something. Those 6-10 colds that children get on average, every year, have arrived which means there’s a good chance you’ll be up late one night with a feverish or coughing child reaching for an over-the-counter (OTC) medicine . Data proves we’re all at risk for making a dosing error. Remarkable how easy it is to do. As a pediatrician I always have to check (and double check) the label when I’m home dosing my kids. The bottles and doses are all so different.
A new study in Pediatrics found that every eight minutes a child under the age of 6 experiences a medication error (outside the doctor’s office or hospital). Over the course of ten years (2002-2012) 696,937 children experienced medication errors. Young children (under age 1) had the highest rate of errors making up more than 25% of the total number. For parents these may be easy mistakes to make as containers and dosing devices aren’t always clear (nor are they consistent) even after FDA rule changes were made a few years back.
It’s important to note that the study referencing dosing errors (above) found dosing errors from cough & cold medicine are thankfully going down while dosing errors around other meds are actually rising. It’s also of import to say that most pediatricians don’t recommend OTC cough and cold meds for children under age 6 anyway as they provide little benefit and put children at risk for side effects and dosing errors.
Why Do Dosing Errors Happen?
- Liquid medications may provoke the most confusion:
- In the Pediatrics study liquid meds accounted for 81.9% of errors overall.
- A 2010 JAMA study found only 74% of OTC medications for children come with a measuring spoon or syringe and often parents aren’t aware that a teaspoon in the drawer may not be a “tsp” of medicine. Of note with medicines, 1 teaspoon = 5mL.
- The same study found that 98% of liquid OTC medications have inconsistencies, excess information or confusing dosing instructions. Yikes!
- Parents on autopilot (medication given more than once):
- 27% of errors attributed to this — we get comfortable at times, and of course we’re all prone to mistakes. We always have to re-look at the dose and dosing device each time we give medicines — this may help.
What Can Parents Do To Prevent Mistakes?
- Always use the measuring device (that syringe, cap, or cup) that comes with the medication! Different bottles come with different devices, use the one that came with.
- Never ever use a spoon from your kitchen drawer and call it a “teaspoon.”
- TIP: Use a rubber band to attach the syringe or cap to the liquid bottle if need be.
- Only give the recommended dose for your child. Call you doctor’s office and talk with a nurse if need be! Here’s a dosing chart for acetaminophen and ibuprofen in babies and young children that can help support you.
- Don’t give children medicine designed for adults — don’t cut adult medications in half or dose your children with medications designed for anyone other than children.
- Keep all medicines out of sight and reach. Ingestions in young children (especially toddlers) are a product of their great curiosity and lagging insight…
- Bring medications to well-child checkups and review doses with your pediatrician or family doc or nurse practitioner. There are no silly questions, having the actual bottle with the dosing device often helps!
This post was written in partnership with OTC Safety.org. In exchange for our ongoing partnership helping families understand how to use OTC (over-the-counter) meds safely they have made a contribution to Digital Health at Seattle Children’s for our work in innovation. I adore the OTC Safety tagline, “Treat yourself and your family with care all year long.” Follow @OTCSafety #OTCSafety for more info on health and wellness.
Sara T says
Since you are on the topic, I have to bring up a pet peeve with Children’s Acetaminophen. While they finally changed the formula so that it didn’t have a different concentration for infant and children, they still sell an infant version and charge double the price. The half priced children’s version purposefully includes a measuring cup that starts at 5ml so that parents who don’t realize that 2.5ml = 1/2 tsp feel like they should buy the infant version. Generic and Name Brands do this. I am a nurse so I bought the children’s version (generic, of course) and measured it in a different medicine cup. Pharmacies are happy to give a cup or syringe for free. They may say there is a safety reason but I think it is greed. Any reason for me to think differently? It isn’t as if the infant version has infant dosages, it just says “Consult a Doctor”.
Thanks for your blog!