Recommended Dose of Iron Syrup for a 1-Year-Old Child
For treatment of presumptive iron-deficiency anemia in a 1-year-old child, prescribe 3 mg/kg per day of elemental iron (as ferrous sulfate drops) administered between meals. 1
Treatment Dosing
The standard therapeutic dose is 3 mg/kg per day of elemental iron, given as iron drops (ferrous sulfate) between meals to maximize absorption 1
This dose should be continued for the initial 4-week treatment period, after which hemoglobin should be rechecked 1
If hemoglobin increases by ≥1 g/dL (or hematocrit by ≥3%) after 4 weeks, this confirms iron-deficiency anemia and treatment should continue for 2 additional months 1
Higher Dose Considerations
Some evidence supports using 5-6 mg/kg per day of elemental iron for treatment of established iron-deficiency anemia, which has been shown effective in clinical studies 2, 3
A dose of 6 mg/kg per day may be needed to correct preexisting iron deficiency or when more aggressive repletion is required 4
The optimal therapeutic response can be achieved with dosages ranging from 3 to 6 mg/kg of elemental iron per day 2
Administration Guidelines
Administer iron between meals (not with meals) to optimize absorption, as food can decrease iron bioavailability 1
Ferrous sulfate is the preferred formulation as it demonstrates better clinical response and fewer adverse effects compared to iron polymaltose complex 5
Divide the total daily dose into 2-3 administrations throughout the day for better tolerance 5
Important Caveats
Always provide dietary counseling concurrently to address the underlying problem of inadequate iron intake 1
Common side effects include mild gastrointestinal symptoms (nausea, vomiting, diarrhea), which should not necessarily prompt discontinuation 1
If the anemia does not respond after 4 weeks despite compliance and absence of acute illness, further laboratory evaluation is needed (MCV, RDW, serum ferritin) 1
Avoid excessive dosing: systemic iron toxicity with hepatocellular damage has been reported with excessive iron administration in pediatric patients 1, 6