From the Guidelines
The recommended dosage of zinc syrup in pediatrics is 20 mg of elemental zinc daily for 10-14 days for children 6 months and older with acute diarrhea, as supported by the 2017 Infectious Diseases Society of America clinical practice guidelines 1. When determining the appropriate zinc syrup dosage, it's essential to consider the child's age and the condition being treated.
- For children with acute diarrhea, the dosage is typically 10-20 mg of elemental zinc daily for 10-14 days.
- Infants under 6 months should receive 10 mg daily, while children 6 months and older should receive 20 mg daily, as this age group is most likely to benefit from zinc supplementation in reducing the duration of diarrhea, as stated in the guidelines 1. Key considerations for zinc supplementation include:
- Administration between meals with water to maximize absorption, as food can decrease zinc absorption.
- Temporary side effects, such as nausea or metallic taste, which usually resolve quickly.
- Storage of zinc syrup at room temperature away from direct sunlight and moisture. The guidelines from the 2017 Infectious Diseases Society of America 1 emphasize the importance of oral zinc supplementation in reducing the duration of diarrhea in children 6 months to 5 years of age who reside in countries with a high prevalence of zinc deficiency or who have signs of malnutrition. Zinc supplementation plays a crucial role in improving intestinal absorption, enhancing immune function, and maintaining intestinal mucosal integrity, ultimately reducing the severity and duration of diarrheal episodes. Common zinc preparations, including zinc sulfate, zinc gluconate, and zinc acetate, are available for pediatric use. Parents should be informed about the potential temporary side effects and the importance of proper storage and administration to ensure the effectiveness of zinc syrup in pediatric patients.
From the Research
Recommended Dosage of Zinc Syrup in Pediatrics
The recommended dosage of zinc syrup in pediatrics varies based on age and weight.
- For children with acute diarrhea, the World Health Organization (WHO) and UNICEF recommend daily 20 mg zinc supplements for 10 - 14 days 2.
- However, a study published in The New England Journal of Medicine found that lower doses of zinc (5 mg or 10 mg per day) had noninferior efficacy for the treatment of diarrhea in children and were associated with less vomiting than the standard 20-mg dose 3.
- For infants under six months old, the WHO and UNICEF recommend 10 mg per day 2.
- The Cochrane review of oral zinc for treating diarrhea in children found that zinc resulted in a shorter diarrhea duration and less diarrhea at days three, five, and seven, but subgroup analyses by age showed no benefit with zinc in children under six months old 4.
Considerations for Zinc Supplementation
- Zinc supplementation is generally considered safe, but it can cause vomiting, especially with the first dose 5, 4.
- The effectiveness of zinc supplementation may vary depending on the etiology of the diarrhea infection and the dose used 5.
- In areas where diarrhea is an important cause of child mortality, research evidence shows zinc is clearly of benefit in children aged six months or more 4.