Syrup is dosed by kilograms, not by one spoonful

The classic study by Li et al. (Pediatric Emergency Care, 2000) found that 51% of parents give an inaccurate dose of the most common children's medicines for fever and pain, with errors even more frequent in babies under 1 year. Much of the problem comes from kitchen spoons: a "teaspoon" in different kitchens holds between 2.5 and 7 millilitres - a difference of nearly three times.

Underdosing leaves the child without effect, and overdosing can be dangerous, especially with paracetamol, where liver toxicity from accumulating doses is a real risk. In both cases the child loses.

Children's doses depend not on age but on weight. The standard recommendations are: paracetamol 10-15 mg per kilogram per dose, ibuprofen 5-10 mg per kilogram per dose. That is why the leaflet tables are in kilograms, and age is only a guide when the weight is unknown.

A practical example: a 10 kg child takes 100-150 mg of paracetamol per dose. How many millilitres that is depends on the concentration of the specific syrup: at 120 mg per 5 ml it is about 4-6 ml, and at a stronger concentration less. So the first thing before giving a dose is to read how many milligrams are in a millilitre of your bottle.

Always use the oral syringe or measuring cup from the package and measure in millilitres, not spoons. Write down the time and dose of every administration, especially at night and when two parents take turns - double dosing is among the most frequent incidents. Respect the daily maximum: with paracetamol no more than 4 doses, with ibuprofen every 6-8 hours.

Ibuprofen is not given to babies under 6 months and is avoided with vomiting and dehydration. Do not combine two fever syrups on your own and do not wake a sleeping, calm child just for a dose. Aspirin is forbidden for children. Whenever you doubt a dose, the pharmacist will calculate it for you in a minute.

This article was written by Donka Arabadzhova, Master of Pharmacy, and confirmed by the following sources: the study by Li et al. on parental dosing accuracy (Pediatric Emergency Care, 2000), the American Academy of Pediatrics weight-based dosing tables and the MedlinePlus guide to children's syrups and measuring devices.