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

Paracetamol Dosage for a 1-Year-Old Child

For a 1-year-old child, administer paracetamol at 10-15 mg/kg per dose every 4-6 hours, with a maximum daily dose of 60 mg/kg per day, not exceeding 5 doses in 24 hours. 1

Weight-Based Dosing Algorithm

For precise dosing in a 1-year-old, use the following weight-based approach:

• If the child weighs <10 kg: Give 15 mg/kg per dose 1
• If the child weighs ≥10 kg: Give 10-15 mg/kg per dose 1
• Dosing interval: Every 4-6 hours as needed 1
• Maximum frequency: Not to exceed 5 doses in 24 hours 1
• Maximum daily dose: Never exceed 60 mg/kg per day 1

Practical Example

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

• Single dose: 100-150 mg (10-15 mg/kg)
• Maximum daily dose: 600 mg (60 mg/kg/day)
• Dosing schedule: Every 4-6 hours, up to 5 times daily 1

Route of Administration Considerations

Oral syrup is strongly preferred over rectal suppositories because oral formulations are absorbed more rapidly and provide more consistent therapeutic response. 1 Rectal acetaminophen should be used cautiously due to erratic absorption, which may result in either inadequate analgesia or risk of accumulation with repeated dosing. 1

Rectal administration should only be considered when:

• The child is actively vomiting 1
• Oral intake is restricted in perioperative situations 1

Critical Safety Parameters

Toxicity prevention is paramount—exposures greater than 140 mg/kg/day for several days carry risk of serious hepatotoxicity. 2 The maximum dose should never exceed 60 mg/kg per day or 5 doses in 24 hours under any circumstances. 1

Single ingestions of more than ten times the recommended dose are potentially toxic and require immediate medical evaluation. 2

Special Clinical Situations

For post-vaccination fever: Paracetamol can be given at the time of vaccination and every 4 hours for 24 hours at 15 mg/kg per dose. 1

For children with history of febrile seizures: While paracetamol at 15 mg/kg can be given prophylactically to reduce fever risk, it will improve comfort but does not prevent febrile seizures. 1

Common Pitfalls to Avoid

• Do not underdose: Many dosing schedules recommend inadequate amounts of paracetamol. 3 The 10-15 mg/kg range is evidence-based and should be adhered to for optimal antipyretic and analgesic efficacy. 4

• Do not rely on age-based dosing alone: For children under 2 years, the FDA label states "Consult a doctor" for age-based dosing. 5 Weight-based dosing is more accurate and safer in this age group. 3

• Avoid cumulative toxicity: Track total daily dose carefully, especially if multiple caregivers are administering medication or if the child is receiving combination products containing paracetamol. 6