What is the recommended dose of paracetamol (acetaminophen) for a 2kg baby?

Paracetamol (Acetaminophen) Dosing for a 2kg Baby

For a 2kg baby, the recommended dose of paracetamol (acetaminophen) is 10-15 mg/kg every 6 hours, which equals 20-30 mg per dose, with a maximum daily dose of 60 mg/kg/day or 120 mg total per day. 1, 2

Dosing Guidelines

• The standard pediatric dosing range for paracetamol is 10-15 mg/kg per dose 1, 2
• For a 2kg infant, this translates to:
  • Per dose: 20-30 mg (2kg × 10-15 mg/kg) 2
  • Maximum daily dose: 120 mg (2kg × 60 mg/kg/day) 3
• Dosing interval: Every 6 hours as needed, with a maximum of 4 doses in 24 hours 1

Special Considerations for Low-Weight Infants

• For very small infants, the lower end of the dosing range (10 mg/kg) may be preferred initially 3
• Careful weight-based dosing is critical in small infants to avoid potential toxicity 3
• Dosing for neonates and infants under 3 months requires extra caution as there are fewer established guidelines 3

Administration

• Liquid formulations are appropriate for infants, but ensure they are infant/pediatric formulations 1
• Use a calibrated oral syringe or dropper for accurate measurement 2
• Avoid adult formulations which may contain inappropriate additives for infants 3

Safety Considerations

• Single doses exceeding 10 times the recommended dose (>100-150 mg/kg) are potentially toxic 1
• Chronic dosing exceeding 140 mg/kg/day carries risk of serious hepatotoxicity 1
• Monitor for signs of overdose including nausea, vomiting, abdominal pain, and lethargy 1
• Ensure all caregivers record administration times to prevent accidental overdosing 4

Indications

• Paracetamol is appropriate for fever (≥37.8°C) and mild to moderate pain in infants 1, 4
• For fever, treatment is primarily indicated when associated with discomfort rather than for temperature reduction alone 1

Duration of Treatment

• Limit treatment to the shortest duration necessary to manage symptoms 4
• Consult a healthcare provider if fever persists beyond 48 hours or if the infant's condition worsens 4

Common Pitfalls to Avoid

• Using adult formulations or inappropriate measuring devices 3
• Exceeding the maximum recommended daily dose of 60 mg/kg/day 3
• Failing to record dose administration times, which can lead to accidental overdosing 4
• Treating fever without associated discomfort (fever alone does not necessarily require treatment) 1