Small Doses for Small Bodies: Why Dosing Matters for Children

Acetaminophen and ibuprofen are staples of any medicine cabinet. These fever and pain-reducing medicines are hugely important for many conditions, from the cold and flu to headaches and post-surgery pain. But while adults are comfortable with tablets, pills, and gel caps that we find on pharmacy shelves, many young children can’t swallow these tablets. In these cases, liquid ibuprofen and acetaminophen are most often the answer. 

While pouring liquid into a teaspoon is a simple way to deliver over-the-counter medicines, administering liquid medication to children comes with serious risks that we may not even consider. Parents today are cautioned to be precise when measuring children’s dosages, especially when liquid medicines are involved. 

Safety by the mL: Safe Use of Liquid Acetaminophen and Ibuprofen for Children

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and medications like acetaminophen can be dangerous in large amounts, but they can also be ineffective in small amounts. The key is to get a precise measurement every time — which is easier said than done. 

In an experiment at Cornell University, test subjects would either pour 8% less medication than needed or 12% more on average. And when you’re dealing with young children, whose bodies are significantly smaller and less developed than the average adult’s, these measurements must be specific. 

“Using a kitchen spoon can lead to overdoses [or underdoses] because silverware is not calibrated to accurately measure medicine,” said Daniel Budnitz, MD, MPH, U.S. Public Health Service, and director of the medication safety program at the Centers for Disease Control and Prevention. 

Dr. Budnitz also told Pharmacy Today that many people will mistake tablespoons for teaspoons, nearly tripling the recommended dosage. Too large a dose of liquid acetaminophen can seriously damage a child’s organs. 

That’s why in 2014 the Consumer Healthcare Products Association updated the OTC voluntary guidelines and deleted all instances regarding spoon dosing, instead emphasizing the importance of mL dosing. 

mL Dosage Cups: a New Industry Standard

Oral syringes and dosage cups and spoons using standard metric mL measurements can help reduce the amount of under and overdoses in children, and make life much simpler for parents and physicians. It’s also important for pharmaceutical companies and plastic packaging manufacturers to improve consistency across the industry. 

Do Your Part to Prevent Accidental Poisoning in Children

comar oral syringes with DoseGuard® shown with a variety of adapters and stands.

Accidents can happen and even the most careful parents and caretakers can be unwitting participants in an unfortunate incident.

Believe it or not, accidental poisoning in the home is an American epidemic. According to reports aggregated in 2021 by U.S. Poison Control Centers, for every 1,000 children under the age of six, 37 poison exposures were reported.

In fact, one instance of poison exposure was reported to U.S. poison control centers every 15 seconds.

What Are the Major Causes of Accidental Poisonings in the Home?

Cosmetics and personal care products are heads and shoulders above the rest of the pack when it comes to accidental poisonings in children ages six and under.

Most often, we equate accidental poisoning in the home with cleaning products stored within easy reach. But, the fact is that, anything can be harmful in excess. Even food!

Health and wellness products come in various shapes and sizes and can often be toxic in the wrong doses.

Substance CategoryNo. Cases%
Cosmetics and Personal Care Products109,32711.8
Household Cleaning Substances104,45911.3
Foreign Bodies, Toys, Miscellaneous62,0046.7
Dietary Supplements, Herbals, Homeopathic59,5756.4
Topical Preparations39,8194.3
(Source:, 2023)

Why Are They So Common?

A child’s health is precious and precarious all at once, and parents do their best to maintain a healthy balance without accidentally putting their child at risk. However, natural occurrences like cold and flu season can throw things off balance.

The general consensus is that keeping potentially harmful substances out of sight and out of reach will keep children safe. However, as mentioned above, many seemingly harmless household items can cause accidental poisoning.

99% of poison exposures are unintentional in children younger than six years. What is the most common cause of accidental ingestion of medications, cosmetics, or cleaning products?

Pure convenience.

Parents and caregivers can often leave comforting medications or disinfectants within easy reach during bouts of sickness or to stave off potential germs during cold and flu season. While this may seem smart, it usually places harmful substances within direct reach of little hands.

What Can You Do to Prevent Accidental Poisoning in Children?

woman pharmacist scanning a bottle in a pharmacy

Combine Packaging Safety Measures

While child-proof packaging is a great start to achieving poison safety in the home, it isn’t always foolproof. But, combining smart child-proof packaging solutions with flow-restricting bottle adapters, or orifice reducers, can reduce the risk of an overdose while still allowing parents to administer the required dosage when needed.

Comar’s patented DoseGuard® valved bottle adapter offers maximum flow control and a passive valve to keep liquid medications safe for everyone, while still being extremely convenient to use.

Encourage Keeping Items in Original Packaging

Most harmful solutions are deliberately packaged with smart child-proof safety measures in place to prevent or reduce the risk of ingestion.

Keeping potentially dangerous items in their original packaging can help ensure that children (and pets) are safe from accidental poisoning by maintaining the integrity of these child-proof safety measures.

Parents can often err on the side of convenience when it comes to some medications or supplements by putting them in another container. Warnings against this behavior can help prevent the risk of potential accidental poisoning on their watch.

Discourage Storage Locations of Convenience

As a manufacturer, we proactively seek to provide safer packaging solutions. But, discouraging medicine storage in convenient areas can significantly reduce the risk of accidental poisoning.

Parents will opt for an easily accessible location for necessary medications or cleansers, especially if they are frequently used or must be available immediately. However, convenient storage can often lead to little ones getting their hands on dangerous substances.

Do your part to discourage this behavior when developing your next custom package, and educate consumers on your website, and social media networks.

Poison prevention in children is easier than you think. Just follow these three simple steps to become a leader in child-proof products in your industry. If you’re in the health and wellness, personal care, or household and industrial industries, contact Comar today to find.