Gave Your Child a Double Dose by Accident? What to Do Now

You gave the syrup because the temperature had climbed again. Twenty minutes later your partner mentions, in passing, that they already gave a dose before bed. It takes a couple of seconds for the sentence to land.

Here is the short version: you do not have to work out how serious this is on your own. Contact 111 for advice now if your child takes any extra doses of ibuprofen, or if you have given more paracetamol than it says on the packet.

What to do in the next few minutes, what not to do, and how to close the gap the extra dose slipped through — section by section below.

What should you do straight away after a double dose?

Get advice rather than waiting to see whether anything happens. Pick up the packet and the leaflet inside it, then get help from 111 online or call 111. Call 111 if you need advice for a child under 5 years old. Do not wait until morning — how long ago the dose was given is part of the assessment.

What you avoid matters just as much. Do not try to make your child sick if you think they have swallowed something harmful — they could choke and stop breathing. Do not give them anything to eat or drink either, unless a health professional tells you to. And do not drive yourself if you are told to go to A&E: ask someone to drive you, or call 999 and ask for an ambulance.

When you call, you will be asked what your child took, how much, and when. That is why the packet matters — the active ingredient and the strength are printed on it, and both come up in the conversation.

How much is too much paracetamol or ibuprofen?

There is no single figure, because the dose is set by your child's age and weight and printed on the packet. What the NHS does give is the timing. Children aged 3 months and over can have paracetamol up to 4 times a day, waiting at least 4 hours between each dose and giving no more than 4 doses in 24 hours.

Ibuprofen works to a similar pattern. You will usually give your child ibuprofen 3 or 4 times a day. If you give it 3 times in 24 hours, leave at least 6 hours between doses; if you give it 4 times in 24 hours, leave at least 4 hours between doses. Do not give ibuprofen to a child aged 6 months or older for more than 3 days without speaking to a doctor.

Two rules cause most accidental doubles. Do not give ibuprofen and paracetamol at the same time, although you can alternate between them if a health professional such as a doctor or nurse tells you to. And avoid other medicine containing paracetamol, such as cold and flu medicine — that is where a "second" medicine quietly turns into a second dose of the same drug. If you are unsure which one to reach for in the first place, we compared them in ibuprofen vs paracetamol for children.

Why do double doses happen in the first place?

Almost never through carelessness. It is the same handful of gaps every time, and all of them are about missing information rather than missing care: the handover between two adults, the fog of the middle of the night, two forms of medicine containing the same drug, and no written time for the last dose.

The most common one is the handover between two adults. One gives a dose at 10pm and goes to bed. The other takes over at 2am and sees a child with a temperature, but no record of what has already been given. The second gap is the night itself: at 2am, a two-minute action from four hours earlier genuinely does not feel like it happened.

Then there is the form the medicine comes in. Syrup and suppositories feel like two different things even when the active ingredient is the same, so whoever is up next reaches for the other one. And finally the clock: without a written time, you reconstruct the gap by feel, and feel reliably underestimates how recent something was in the middle of the night.

How do you keep a complete record of every dose?

Four details prevent almost every double dose: the time, the medicine, the dose and who gave it. The last one gets left out most often, and in a household with two adults it is the one that matters most.

That is what the medicine log in Mona is built for. You enter the dose with its timestamp right after the syringe, before you put your child back down — and if your partner is following the same timeline, they see it before they reach for the packet. A note on the kitchen worktop cannot do that job at 2am, because nobody turns the lights on to go and read it.

The same entry pays off again at the surgery. Your GP will ask what your child had, how much, when the last dose was, and how many doses there have been in the past 24 hours. Those four answers are already written down, rather than reconstructed at seven in the morning on no sleep.

What if your child spits the dose out or is sick?

Do not simply give it again. If your child vomits shortly after a dose, get advice before repeating it — from 111, your pharmacist or your GP. This applies even when you are certain that most of it came straight back up, because there is no way to judge from the outside how much was actually absorbed.

The same logic runs in the other direction. If you miss a dose, do not give a double dose to make up for it. Carry on with the next scheduled dose instead, keeping the minimum gap for that medicine.

Either way, write down what happened. A dose that was spat out or brought back up belongs in the timeline with its time — otherwise it turns into the next uncertainty at 3am: did that count as a dose or not?

How do you stop it happening again?

The strongest single fix is a fixed role. Decide before the night who is giving medicines, and keep that through until morning rather than swapping with whoever wakes up. Whoever takes over reads the last entry first and picks up the packet second.

Second, put the light on before you measure. In half-darkness it is easy to draw up the wrong amount, and a kitchen spoon is not a measuring device in any case. Use the oral syringe or spoon that came with the medicine, and ask your pharmacist for one if you do not have it.

Third, log the dose before you put your child back down, not afterwards. The entry made afterwards is the one that never happens. If doses regularly go wrong — spat out, refused, half-taken — mention it to your pharmacist or GP rather than working around it every night.

Common questions about accidental double doses

Should I call straight away or wait and see?

Call rather than wait. Contact 111 for advice now if your child takes any extra doses of ibuprofen, or if you have given more paracetamol than the packet, leaflet or prescription says. How long ago the dose was given forms part of the advice you get, so waiting until morning removes options. If your child is seriously unwell, unconscious or struggling to breathe, call 999.

What if it was only slightly too much?

That is still a call worth making, and it is a short one. The assessment depends on the medicine, the amount and your child's age and weight, and the person on the phone does that calculation with you. Have the packet and leaflet to hand, along with the time of both doses.

Can I give paracetamol and ibuprofen together?

Do not give ibuprofen and paracetamol at the same time. You can alternate between them, but only if a health professional such as a doctor or nurse tells you to. If you are alternating on medical advice, write down every single dose with the medicine name and time — otherwise you are tracking two separate intervals in your head at once.

How long do I have to leave between doses?

For paracetamol, wait at least 4 hours between each dose and give no more than 4 doses in 24 hours. For ibuprofen, leave at least 6 hours between doses if you give it 3 times a day, or at least 4 hours if you give it 4 times a day. The binding figure for your specific bottle is on the packet, because strengths differ.

How will I know if my child is not coping with the extra dose?

Do not rely on that signal. Whether an amount matters depends on the medicine, the dose and your child's weight, not on how they seem in the moment. That is why the call goes at the start and not at the end. If your child is unconscious, having a fit or struggling to breathe, call 999 without waiting.

What if we are not sure whether a double dose was given?

Treat it as one and call. "We are not sure" is an ordinary answer on that phone call, and advice is given on the more cautious assumption. Then close the gap: from the next dose onwards, every one gets written down with a time, so the question stops coming up.

Summary: 999, 111 or keep an eye?

Situation	What to do
Unconscious, having a fit, or struggling to breathe	Call 999 or go to A&E
Extra dose given, child awake and responsive	Call 111 or get help from 111 online, packet to hand
Not sure whether a dose was doubled	Treat it as a double dose and call 111
Dose spat out or vomited	Do not repeat it — get advice first
Correct gap kept, child settled	Keep watching and log every dose with its time in Mona