Daily Zinc Dose for a 7-Year-Old Child
For routine supplementation in a healthy 7-year-old child, give 50 μg/kg/day of elemental zinc, with a maximum of 5 mg/day. 1
Standard Dosing for Routine Supplementation
The recommended dose is 50 μg/kg/day (up to 5 mg/day maximum) for children older than 12 months, as established by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). 1
For a typical 7-year-old weighing approximately 20-25 kg, this translates to approximately 1-1.25 mg of elemental zinc daily, not exceeding the 5 mg/day cap. 1
Zinc is best absorbed when given between meals rather than with food, and should be administered in divided doses throughout the day for optimal tolerability. 1
Special Circumstances Requiring Higher Doses
For Documented Zinc Deficiency
- Therapeutic doses of 0.5-1 mg/kg per day of elemental zinc should be given for 3-4 months when zinc deficiency is confirmed. 1
- For a 20-25 kg child, this would be 10-25 mg daily, substantially higher than routine supplementation. 1
For Acute Diarrhea
- Give 10-20 mg of elemental zinc daily for 10-14 days during episodes of acute diarrhea, particularly in children with signs of malnutrition or in regions with high zinc deficiency prevalence. 2
- Lower doses (10 mg) are associated with significantly less vomiting compared to the standard 20 mg dose (15.6% vs 19.3% vomiting within 30 minutes), while maintaining equivalent efficacy for diarrhea treatment. 3
For Children with Increased Losses
- Higher supplementation may be required for children with increased gastrointestinal fluid losses, diarrhea, or severe skin disease. 1
Administration Guidelines
- Avoid giving zinc with foods high in phytates (whole grains, legumes), which reduce absorption. 1
- Do not co-administer zinc with iron supplements at the same time, as iron decreases the beneficial effects of zinc. 4
- Different zinc salts (sulfate, acetate, gluconate) have equivalent efficacy, though organic compounds may have better tolerability than inorganic forms. 1
Monitoring Requirements
- For children on long-term zinc supplementation, monitor serum zinc levels and alkaline phosphatase periodically to ensure adequacy and avoid toxicity. 1
Common Pitfalls to Avoid
- Do not confuse routine supplementation doses with therapeutic doses for Wilson's disease (75 mg for children <50 kg), which is a completely different clinical context requiring much higher zinc intake. 5
- Gastric irritation is the most common side effect, which can be minimized by using divided doses and selecting better-tolerated zinc salts. 5
- Zinc supplementation should not replace oral rehydration therapy during diarrheal illness—rehydration remains the cornerstone of management. 2