The American Academy of Pediatrics (AAP) is urging parents, physicians and pharmacists to measure their children's medicine more precisely.

The AAP's statement asks that anyone administering or prescribing medicine to children drop the spoon and stick to metric measurements available on product labels and dosing cups.

"Spoons come in many different sizes and are not precise enough to measure a child's medication," said pediatrician Ian Paul, lead author of the policy statement, "Metric Units and the Preferred Dosing of Orally Administered Liquid Medications," in the April 2015 Pediatrics. "For infants and toddlers, a small error - especially if repeated for multiple doses - can quickly become toxic."  

Every year more than 70,000 children visit the emergency room due to unintentional medication overdose. In some cases the overdose occurs because a caretaker mistakes milliliters for teaspoons, causing them to administer an incorrect dose of up to three times as much as is recommended.

"One tablespoon generally equals three teaspoons. If a parent uses the wrong size spoon repeatedly, this could easily lead to toxic doses," Paul said.

The researchers noted common over-the-counter liquid medications for children tend to have metric dosing on the label but include a measuring device marked in teaspoons, or vice versa. This system can cause caregivers to become confused and administer the incorrect dose.

The recent statement suggests a "common language" be adopted, such as mL as the only appropriate abbreviation for milliliters and clear dosing frequency words such as "daily" included on the label. The academy said manufacturers should stop putting any measurements on labels other than milliliters. Pediatricians should also review mL-based doses with families when prescribing the medicine.

"We are 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," Paul concluded.