In a new Policy Statement, the AAP is calling for “a simple, universally recognized standard that will influence how doctors write prescriptions, how pharmacists dispense liquid medications and dosing cups, and how manufacturers print labels on their products”:

The AAP urges parents, physicians and pharmacists to use only metric measurements on prescriptions, medication labels and dosing cups to help ensure kids receive the correct dose of medication. Medication should not be measured in teaspoons or tablespoons, especially not spoons taken from a kitchen drawer.


Kitchen utensils like teaspoons and tablespoons vary in size and shape. Confusion in dosing and volumetric errors are common with these inaccurate instruments used for measuring children’s medications. Especially for infants and small children, small measuring errors can lead to big problems. The AAP reports:

Each year more than 70,000 children visit emergency departments as a result of unintentional medication overdoses. Sometimes a caregiver will misinterpret milliliters for teaspoons. Another common mistake is using the wrong kind of measuring device, resulting in a child receiving two or three times the recommended dose.


The new AAP Policy Statement recommends:

  • Standard language should be adopted, including mL as the only appropriate abbreviation for milliliters. Liquid medications should be dosed to the nearest 0.1, 0.5, or 1 mL.
  • How often a dose is needed should be clearly stated on the label. Common language like “daily” should be used rather than medical abbreviations like ‘qd’, which could be misinterpreted as ‘qid’ (which in the past has been a common way for doctors to describe dosing four times daily).
  • Pediatricians should review mL-based doses with families when they are prescribed.
  • Dosing devices should not have extra markings that can be confusing, and should not be significantly larger than the dose described on the label, to avoid two-fold dosing errors.
  • Manufacturers should eliminate labeling, instructions and dosing devices that contain units other than metric units.


Read more from the American Academy of Pediatrics 2015 Policy Statement regarding “Metric Units and the Preferred Dosing of Orally Administered Liquid Medications” here.