Bad Medicine: Why Children’s Dosing Instructions are so Confusing

I don’t like to take over-the-counter medicine, and I certainly don’t enjoy giving it either. But on occasion, when someone (namely my child) is suffering from a sustained fever and are in desperate need of a night of uninterrupted sleep, I am not above reaching for the children’s Tylenol (or, considering all of the recent recalls, the generic equivalent) and allaying the pain for just a few hours. While I consider myself to be both consumer savvy and a fairly quick learn when it comes to following directions, struggling with the directions printed on a bottle of liquid medicine can be a chore and supremely confusing, especially at 2AM.

Evidently I am not alone with this complaint. According to a recent study by The Journal of the American Medical Association, labels on 98% of children’s over-the-counter medications sold in 2009 have confusing instructions that can lead to under or overdosing. While fatalities from these sorts of overdoses are extremely rare, it is all too easy to make a mistake and unwittingly put your kid to sleep for a long while with a bonus dose of Benadryl. One of the most common mix ups occur often because, while the directions on the bottle give teaspoon measurements, the dosing cup is marked with milliliters, or the ml abbreviation. If your child is running a fever of 102 and you are sleep deprived, 2 ml can seem a lot like 2 tbs. And forget about using kitchen spoons, as the size differential can be enormous.

While the FDA has issued new draft guidelines aimed at making the dosing of these over-the-counter meds less confusing, many medical experts are pushing for the industry to adopt one unit of measurement to simplify matters (this harkens back to move to metric conversion that never gained traction in the 1970s). And reports indicate that even with the new FDA guidelines, dosage instructions tend to be highly variable and inconsistent.

Is it time to go metric, for the sake of the children? Or at least to keep them properly medicated? Are these sweeping changes worth the trouble, or is this just the sort of thing that angers Libertarians and those who feel we are raising a nation of whiners (albeit a nation of whiners overdosed on cold meds)?


jane richmond
jane richmond7 years ago

Once we figure it out we'll be fine. I hope.

Sabina K.
Sabina K.7 years ago


Walter G.
Walter G7 years ago

here in the Orient, we have little key ring like measuring spoons all in a set. Even handier and less messy is a 1 oz shot glass calibrated in Ml, and spoons, as well as divided oz. We keep several hypodermic cylinders locked up without needles which can be marked for the amount. that way if we want to carry a pre-measured dose with us, no problem, BUT we must always carry the parent container with the prescription on the label, as Law un-enforcement here seeks out every angle to get a bribe, as unlawful possession of medications is a big capital punishment bribe.

Barbara Erdman
Barbara Erdman7 years ago


Alicia N.
Alicia N7 years ago

noted with thanks....

Petra Luna
Petra Luna7 years ago

Thing is, they do it by age/weight. What if your 5 year old is less than that, or your 10 year old is more than that? I'm guessing you go by weight, then why is the age on there?

Rose N.
Past Member 7 years ago

Thank you for posting.

Lois K.
Lois K7 years ago

Instead of milliliters OR teaspoons, they should mark each dosage by the weight of the child. "Fill to this line for 30 lbs. and under;" "Fill to this line for 31-60 lbs," and so on. This would probably be much easier than trying to figure out how many milliliters equals a teaspoon, and if you are giving the correct dosage.

Mary L.
Mary L7 years ago

I still have a pediatric dosage eye dropper. It's a lot less difficult than other methods for children's liquid medicine. Some might actually get down a baby's throat.

Kathy K.
Kathy K7 years ago

Thanks for the info.