Using a kitchen spoon for medication dosing. Admit it, you've probably done it at one time or another to give yourself -or your kids- cold or fever medicine when you can't find the dosing cup. It's no big deal, a teaspoon's a teaspoon and a tablespoon's a tablespoon, right? NO! The FDA advises against the practice but experts say it happens all the time. According to new research in the Annals of Internal Medicine, spoon dosing is a leading cause of dosing errors and pediatric poisonings. One of the study's researchers, Koert van Ittersum, PhD, of Georgia Tech explains the problem and what you need to know to keep your family safe.

GT: Doctor van Ittersum, can you start by telling us how common it is that people use kitchen spoons to determine the dose of their medicine?
Dr. van Ittersum: Research has shown that many people have a strong tendency to open their kitchen drawer and grab a spoon, any spoon, to administer liquid medicines. There may be different reasons for that. Sometimes we can’t find the measuring device that came with the medicine, sometime we may feel that the device is not appropriate (e.g., a measuring cup for a 2-year old does not work well [personal experience]), and sometimes we feel it may be the best way to administer medicine.

GT: Why is using a kitchen spoon a problem?
Dr. van Ittersum: Our research demonstrates that the size of the spoon one uses tends to influence how much we pour. The problem then becomes that we simply under- or overdose on the medicine. As we write in the paper, for a single serving of cough medicine for an adult this may not be a huge deal. However, things might start adding up when taking medicines two or three times per day for multiple days. Or, when medicating children, the risks increase. And of course, this depends on the type of medicine. More and more liquid medicines contain acetaminophen. Consuming too much acetaminophen can result in illness, liver failure and even death. And there are, of course, many other types of medicines with serious overdosing risks, such as antibiotics or anti-inflammatories. To make these medicines easy to administer to children, they often come in liquid form.

GT: How inaccurate can the spoons be?
Dr. van Ittersum: Well, that depends in part on the size of the spoon. In our research, subjects exceeded the recommended dose by an average of 11.6% when using a large spoon, and underdosed by 8.4% with a medium-sized spoon.

GT: Is it ever OK to use a spoon and are some spoons more risky than others?
Dr. van Ittersum: As said, if you are taking cough medicine just once to suppress an early cough, it probably is not a huge deal. However, when taking liquid medicines for multiple days, especially when children are involved, I would suggest not to use spoons, ever. Sometimes people ask me, how about using a teaspoon? Even with teaspoons there are risks. Research has shown that teaspoons come in many sizes. So, while in the old days, a teaspoon may have actually represented 5 mL, nowadays that is not guaranteed. The risks of misdosing are largest with larger spoons, simply because there is more room for error. Also, as our research showed, depending on the size of these spoons, one runs the risk of either under- or overdosing.

GT: Are kids particularly at risk for injury from issues arising from spoon dosing?
Dr. van Ittersum: As children’s body masses are smaller they tend to be more at risk. As we write in our paper, “Spoon dosing has been identified as 1 of the 3 major causes of dosing errors and pediatric poisoning.” In sum, in accordance with the FDA, we strongly recommend against using kitchen silverware to dose liquid medicine. Instead, use the measuring devices that come with the medicine!

Koert van Ittersum, PhD is an assistant professor at Georgia Tech. He conducts research to (1) improve consumer welfare and (2) increase new product introduction success rates. His research on consumer welfare examines behavioral biases that stimulate overconsumption of drinks, food, alcohol, and medicines and overspending of money. Based on this research, Dr. Van Ittersum formulates marketing strategies that offer win-win solutions for consumers and companies.

Dr. Van Ittersum’s research has resulted in publications in leading journals in marketing (Journal of Consumer Research, Journal of Marketing, Journal of Marketing Research), medicine (British Medical Journal, Annals of Internal Medicine), and agricultural economics (European Review of Agricultural Economics, Journal of Agricultural Economics). His work is widely cited in marketing, medicine, nutrition and dietetics, food science and technology, public, environmental, and occupation health, psychology, and economics and has drawn extensive media attention (e.g., The Wall Street Journal, The New York Times, LA Times, Forbes, USA Today, Associated Press, ABC News, MSNBC, CBS News, BBC News, The Times of London, Canadian Broadcasting Corporation, Daily Telegraph (Australia), United Press International). He has received over $1.3 million in research grants from national and international governments and businesses (e.g., Unilever, Deere & Company).Dr. Van Ittersum teaches Strategic Brand Management at the undergraduate, MBA, and Exec levels.

Comments (2)

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spoon dosing
written by kayla101, April 13, 2010

hmm this article maybe true bt i have received medicine by spoon dosing and have administered over a period of time n nothin serious resulted from it.

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Just for clarification
written by eagr, January 20, 2010

Dr. Ittersum has a doctorate in Marketing and Consumer Behavior. I don't have a problem with that specifically, but if he's writing an article like this that has to do with medicine and dosing, I think it should be made clear that he is not a medical doctor

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