Lactulose Dosage for a 12-Month-Old Child
For a 12-month-old child, the recommended initial daily oral dose of lactulose is 2.5 to 10 mL in divided doses. 1
Dosing Guidelines
- For infants, the FDA-approved dosage of lactulose is 2.5 to 10 mL per day in divided doses 1
- For older children (beyond infancy), the total daily dose is 40 to 90 mL 1
- The therapeutic goal is to produce 2-3 soft stools daily 1
- Dose should be immediately reduced if diarrhea occurs 1
- If diarrhea persists despite dose reduction, lactulose should be discontinued 1
Administration Considerations
- Lactulose is available as an oral solution that can be measured with an appropriate measuring device 1
- For infants younger than 1 year, use a 3-mL or 5-mL oral syringe for accurate measurement rather than the syringe that may be supplied with the medication 2
- Lactulose can be mixed with water, milk, or fruit juice to improve palatability 1
Monitoring and Adjustments
- Monitor stool frequency and consistency to guide dosage adjustments 1
- Clinical improvement may be observed within 24-48 hours but could take longer 1
- Adjust dose every 1-2 days to achieve the target of 2-3 soft stools daily 1
- Watch for signs of excessive effect (diarrhea, abdominal cramping) 1, 3
Mechanism of Action
- Lactulose increases small bowel water content and stimulates small bowel motility 4
- It acts as a prebiotic that can modify intestinal flora 5
- The laxative effects of lactulose are dose-related 3
Special Considerations
- Pediatric dosing cannot be directly scaled down from adult dosing based solely on weight 6
- Children aged 12 months are in a transitional phase where both weight and body surface area considerations may be relevant for dosing 7
- Lactulose has been shown to increase stool frequency, weight, volume, and water content compared to placebo 3