What is the recommended dose of Tylenol (acetaminophen) for a 1-year-old child?

Acetaminophen Dosing for a 1-Year-Old Child

The recommended acetaminophen dose for a 1-year-old child is 10-15 mg/kg every 4-6 hours, not to exceed 5 doses in 24 hours. 1

Weight-Based Dosing Recommendations

• Acetaminophen should be dosed at 10-15 mg/kg per dose at 4-hour intervals for optimal fever reduction and pain control in children 1
• This dosing range has been shown to achieve adequate plasma concentrations for therapeutic effect while maintaining safety 1, 2
• The maximum daily dose should not exceed 75 mg/kg/day to prevent potential hepatotoxicity 3

Administration Considerations

• Acetaminophen is available in multiple formulations for children:

  • Liquid suspension (most common for this age group)
  • Suppositories
  • Chewable tablets (generally not appropriate for 1-year-olds) 4

• For accurate dosing:

  • Always use the measuring device provided with the medication 4
  • Calculate dose based on the child's weight rather than age for precision 2
  • Check the concentration of the formulation (typically 160 mg/5 mL for children's liquid) 2

Clinical Pearls and Pitfalls

• Common dosing errors include:

  • Underdosing (27% of parents give less than 10 mg/kg), resulting in inadequate fever control or pain relief 4
  • Overdosing (12% of parents give 20 mg/kg or more), increasing risk of toxicity 4
  • Administering doses too frequently (some parents dose as often as every 2-3 hours) 4

• For post-vaccination fever prevention, acetaminophen can be given at the time of vaccination and every 4 hours for 24 hours 5

• For children with history of febrile seizures, acetaminophen at 15 mg/kg can be given prophylactically to reduce fever risk 5

Sample Calculation

For a typical 1-year-old weighing 10 kg:

• Minimum effective dose: 10 mg/kg × 10 kg = 100 mg per dose 1
• Maximum recommended dose: 15 mg/kg × 10 kg = 150 mg per dose 1
• Maximum daily amount: 5 doses × 150 mg = 750 mg per day 1, 4

Important Safety Considerations

• Pharmacokinetic modeling suggests that 10 mg/kg may be at the lower end of therapeutic effect, while 15 mg/kg more reliably achieves therapeutic plasma concentrations 2
• Standard manufacturer dosing recommendations may not be optimal across all weight ranges within an age group; weight-based dosing is more accurate 2
• Parents should be educated about proper dosing to avoid both under-treatment and potential toxicity 4