How to Measure Children’s Medication Doses Correctly at Home

Getting the right dose of medicine for your child isn’t just important-it can be life-saving. A teaspoon of liquid medicine might seem simple, but if you’re using a kitchen spoon instead of the right tool, you could be giving your child too much-or too little. Studies show that 7 in 10 parents make at least one dosing mistake with liquid medications, and many of those errors happen at home. The difference between 0.5 mL and 5 mL? That’s a tenfold error. For a child, that can mean the difference between treatment and emergency care.

Why Using Kitchen Spoons Is Dangerous

You might think a regular teaspoon is close enough. It’s not. A standard kitchen teaspoon holds anywhere from 3.9 to 7.3 milliliters (mL), depending on how full it is and the shape of the spoon. But the medical standard for a teaspoon is exactly 5 mL. That’s a 20% to 200% variation. For a child weighing 10 kilograms, a dose of amoxicillin might be 2.5 mL. If you use a kitchen spoon that holds 7 mL, you’re giving almost three times the right amount. That’s not a typo. That’s a real risk.

The Centers for Disease Control and Prevention (CDC) made this clear in their PROTECT initiative: never use kitchen utensils to measure children’s medicine. Even if you’ve done it before without problems, you’re playing with fire. The same goes for tablespoons. They’re even more unpredictable. One parent in Sydney told me they used a tablespoon for their toddler’s fever medicine-because it was the only thing handy. The child ended up in the ER with vomiting and drowsiness. The dose was double what it should have been.

Use Only the Tool That Comes With the Medicine

When you pick up a prescription for liquid medicine, there’s almost always a dosing tool inside the box. It might be a plastic syringe, a dropper, or a small cup. That tool is calibrated for that specific medicine. It’s not a suggestion-it’s part of the safety system.

The CDC and the American Academy of Pediatrics (AAP) both say: use only the measuring device that comes with the medication. Don’t swap it out for a different syringe or a cup you found in the drawer. Even if the new tool looks similar, the markings might be off. A syringe from another bottle might be labeled in teaspoons instead of mL. That’s a trap.

Some pharmacies still print instructions like “give 1 tsp” on the label. That’s outdated and dangerous. Ask the pharmacist to rewrite it in mL. If they don’t, write it yourself on the bottle with a permanent marker. Always double-check the concentration. Amoxicillin might be 250 mg per 5 mL, or 400 mg per 5 mL. The dose changes completely based on that number.

Oral Syringes Are the Gold Standard

For doses under 5 mL, an oral syringe is the most accurate tool you can use. Studies show oral syringes are 94% accurate. Dosing cups? Only 76%. For small doses like 1.5 mL or 2.5 mL, cups are especially bad-error rates jump to nearly 70%. That’s because it’s hard to see the line clearly, and liquid sticks to the sides.

Oral syringes come in different sizes: 1 mL, 3 mL, 5 mL, 10 mL. Use the smallest one that fits your dose. A 10 mL syringe for a 2 mL dose is like using a measuring jug to pour a shot of whiskey-you can’t be precise. Hold the syringe vertically when you draw up the medicine. Look at the plunger at eye level. The liquid forms a curve called a meniscus. Read the measurement at the bottom of that curve.

Some syringes have color-coded tips. For example, red might mean fever medicine, blue for antibiotics. These aren’t gimmicks-they’re safety features. A 2022 study found color-coded syringes reduced dosing errors by 61%. If your pharmacy doesn’t give you one, ask for it. Or buy one at a pharmacy. They cost less than $5.

Never Mix Up mg and mL

This is one of the most common-and deadly-mistakes. Medication labels list two numbers: the strength (mg) and the volume (mL). For example: “Amoxicillin 400 mg per 5 mL.” That means every 5 mL of liquid contains 400 mg of medicine.

Parents often confuse the two. They see “400 mg” and think that’s the dose. But the doctor prescribed “15 mg per kg.” So if your child weighs 15 kg, the dose is 225 mg. Now you have to figure out how many mL that is. Here’s how:

• Weight: 15 kg
• Dose: 15 mg/kg
• Total dose: 15 × 15 = 225 mg
• Concentration: 400 mg per 5 mL
• So: 225 mg ÷ 400 mg = 0.5625
• 0.5625 × 5 mL = 2.8 mL

You don’t need to be a math expert. Most apps and online calculators can do this for you. But always double-check with your pharmacist. If the label says “give 2.8 mL,” don’t guess. Use your syringe. Round to the nearest tenth if your syringe allows it. Never round up unless told to.

Weight Matters-Convert Pounds to Kilograms

Children’s doses are almost always based on weight-not age. That’s why your doctor asks for your child’s weight. If your scale only shows pounds, you need to convert. One kilogram equals 2.2 pounds. So a 22-pound child is 10 kg (22 ÷ 2.2 = 10). A 44-pound child is 20 kg.

If you’re unsure, write it down: Weight in pounds ÷ 2.2 = Weight in kilograms. Keep this number handy. Many parents write it on the medicine bottle or stick it on the fridge. If your child’s weight changes by more than 2 kg, check the dose again. Growth spurts happen fast.

What to Do When Your Child Spits Out the Medicine

About 68% of parents report their child spits out or refuses liquid medicine. It’s frustrating. But don’t give more to make up for it. That’s how overdoses happen.

Instead, try these tricks:

• Use the syringe to place the medicine on the inside of the cheek, not the front of the tongue. Kids can’t spit it out as easily.
• Give a small amount at a time-0.5 mL at a time-and pause between each.
• Let your child suck the medicine off the syringe instead of pushing the plunger.
• Mix it with a small spoonful of applesauce, yogurt, or juice (only if the medicine allows it-check the label or ask your pharmacist).

Never mix it into a full bottle of milk or juice. If they don’t drink it all, they won’t get the full dose. And never force it. Stress makes kids more likely to resist next time.

Shake It Before You Use It

Many liquid medications are suspensions-meaning the medicine floats in liquid. If you don’t shake it, the medicine settles at the bottom. One study found that parents who didn’t shake their child’s antibiotic suspension gave doses that were 30% to 50% too low.

Shake the bottle hard for 10 seconds before each dose. Even if it looks mixed, shake it anyway. Don’t skip this step. It’s not optional.

Keep a Dosing Chart

Create a simple chart for your child’s most-used medicines. Write down:

• Medicine name
• Concentration (e.g., 250 mg/5 mL)
• Dose per kg
• Weight in kg
• Volume per dose in mL
• How often to give it

Put it on the fridge or save it in your phone. When your child is sick and you’re tired, this chart is your safety net. Many hospitals, like Children’s Healthcare of Atlanta, give these out for free. Ask yours for one.

What to Do If You Make a Mistake

If you accidentally give the wrong dose, don’t panic. But don’t wait either.

• If you gave too much: Call your doctor or poison control immediately. In Australia, call 13 11 26.
• If you gave too little: Don’t double the next dose. Just give the right amount at the next scheduled time.
• If you’re unsure: Call your pharmacist. They’re trained for this. They won’t judge you.

Most errors are caught before they cause harm. But you have to act fast. Keep the medicine bottle and the dosing tool with you when you call. That helps them give you better advice.

What’s Changing in 2026

The system is getting better. The FDA now requires that all new pediatric liquid medications come with a dosing syringe marked in mL only. By 2026, 95% of these medicines will follow this standard. Pharmacies are starting to hand out color-coded syringes automatically. Apps like MedSafety use your phone’s camera to show you exactly how much to draw up.

But the biggest change? Awareness. More parents now know that teaspoons are unsafe. More doctors are writing “2.5 mL” instead of “½ tsp.” It’s not perfect yet-but it’s getting safer.