How to Prescribe PediaSure
PediaSure is a pediatric nutritional supplement, not a medication requiring weight-based dosing—prescribe it as a complete or supplemental nutrition source providing 1 kcal/mL, with typical volumes of 240-960 mL daily (divided into 3-4 servings) for children ages 1-10 years, adjusted based on the child's caloric needs and tolerance.
Understanding PediaSure as a Nutritional Product
PediaSure is fundamentally different from medications—it's an enteral nutrition formula designed to meet the nutrient needs of children 1-6 years of age who cannot maintain adequate oral intake 1. The product provides complete, balanced nutrition at 1 kcal/mL concentration and can serve as either a sole nutrition source or supplemental feeding 1.
Prescribing Approach by Clinical Scenario
For Children with Inadequate Oral Intake or Growth Concerns
- Calculate the child's estimated energy requirements based on age, weight, and activity level, then prescribe PediaSure to provide at least 90% of these requirements if used as primary nutrition 1
- Typical starting volumes: 240 mL (8 oz) three times daily for supplemental nutrition, or up to 960 mL daily for complete nutritional support, divided into 3-4 servings 1
- Monitor growth parameters including weight, length/height, weight-for-age, triceps skinfold thickness, and mid-arm circumference throughout treatment 1
For Severely Malnourished Children (Rehabilitation Phase)
- Use PediaSure as the primary caloric source during initial 2-week rehabilitation after management of acute medical complications 2
- Expected outcomes: Average weight gain of 7.5 g/kg/day with significant improvement in Z-score weight-for-age over 2 weeks 2
- Excellent gastrointestinal tolerance has been demonstrated with minimal risk of diarrhea in this population 2
For Chronically Disabled Children Requiring Specialized Support
- Prescribe for 12-week periods minimum to adequately assess efficacy in promoting growth and maintaining nutritional status 1
- Ensure daily intake provides at least 90% of estimated energy requirements for optimal results 1
- Monitor biochemical parameters including serum potassium, though clinically significant changes are rare 1, 2
Practical Prescribing Instructions
Written Prescription Format
- Product name: PediaSure (specify flavor if patient preference known)
- Volume per serving: 240 mL (8 oz)
- Frequency: 3-4 times daily
- Total daily volume: 720-960 mL (adjust based on caloric needs)
- Duration: Ongoing until nutritional goals met
- Instructions: Shake well before use; may be served chilled or at room temperature
Important Clinical Considerations
- Age range: PediaSure is formulated specifically for children 1-10 years of age 1
- Do not use in infants under 1 year without specialized pediatric nutrition consultation, as they have different nutritional requirements 3
- Acceptance and tolerance are typically excellent with minimal gastrointestinal side effects 1, 2
Monitoring Strategy
- Anthropometric measurements: Obtain weight, length/height, and growth indices at baseline and every 2-4 weeks 1
- Clinical assessment: Monitor for improved energy levels, activity, and overall clinical status 1
- Biochemical monitoring: Check basic metabolic panel if using as sole nutrition source for extended periods, though routine monitoring is generally not necessary 1, 2
Common Pitfalls to Avoid
- Do not confuse PediaSure with medications requiring precise mg/kg dosing—it is a nutrition product prescribed by volume based on caloric needs 1
- Do not use the FDA dosing chart provided 4, as this appears to be for a different pediatric product (likely acetaminophen) and is completely irrelevant to PediaSure nutritional supplementation
- Avoid inadequate volumes—prescribing only 1-2 servings daily may not provide sufficient caloric supplementation to impact growth 1
- Do not prescribe for infants under 12 months without specialized guidance, as they require age-specific formulations with different nutrient profiles 3