How to Measure Medicine, Mary Poppins

Posted on Posted in DrDownload

So it’s official. Kids, I’ll no longer be asking you to take a teaspoon of medicine. I’m making the call to action for the pharmacists who prepare prescriptions for my patients to kick back any prescriptions if I forget to write in mililiters.

The AAP came out with the wise advice that pediatricians should only write prescriptions using metric measurements. There are going to be some frustrated Grandmothers with these new recommendations, but it’s the right thing to do. I know… I know: Mary Poppins did sing that song: ‘A teaspoon of sugar helps the medicine go down,’ but as I see things, she should have been measuring out milliliters of the yucky stuff instead of using a kitchen spoon (and for the record, sugar’s not all that good for kids either… but that’s a topic for a different blog.)

Thanks to some important nudging, AAP pediatricians have finally arrived at our long overdue recommendation: no more kitchen teaspoons measuring medicine for kids.  It’s just not accurate enough to measure properly. Dosing syringes with the measurement in metric milliliters are the way to go.

Why the change? For years we have known that kitchen spoons vary widely in the amount of liquid they hold. In those Mary-Poppin-days gone by, mothers had nothing BUT a kitchen spoon to give medicine. Not so today. One teaspoon is supposed to equal five milliliters.  Believe it or not, there is no consistent standard for spoon size among silverware manufacturers. Today, we have a far superior option in the dosing syringe. Thank your pharmacist. Many actually hand out dosing syringes with prescribed medicines, and lots of over-the-counter medicines come with them, too.

Most dosing syringes are marked with BOTH milliliters and with teaspoon fractions in this time of transition. Now that the AAP has raised its very powerful voice of advocacy to ask that we write our prescriptions using metric measurements, it’s my hope that very soon, dual marking will be unnecessary. By removing the teaspoon measurement from our instructions to parents, we will remove the temptation to open the kitchen drawer.  Times change.  So must we.

It’s a staggering statistic when a parent reaches for the kitchen spoon to measure a medicine that there are more than 70,000 ER visits for unintentional medicine overdoses.  Parents give the wrong amount of a medicine assuming they’ve gotten it close enough far more often than you’d imagine. Think about it. Could you actually measure a quarter of a teaspoon of medicine for your child before tossing the spoon into the dishwasher?  “Close enough” only counts in horseshoes and hand grenades. From now on, find the medicine dosing syringe. My prescriptions will insist that you do.

Measuring for your child’s health and brushing up on my metric equivalents, and thanking you for helping me transition on this one, I am

Gayle Schrier Smith, MD

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