What is the recommended daily dose in mL of ferrous sulfate oral drops for a 15.2 kg child for 3 months?

Ferrous Sulfate Dosing for Iron Deficiency Anemia in a 15.2 kg Child

For a 15.2 kg child with iron deficiency anemia, prescribe 2 mL of ferrous sulfate oral drops (15 mg iron/mL concentration) once daily, delivering 3 mg/kg/day of elemental iron (approximately 45.6 mg total elemental iron daily) for 3 months.

Dosing Calculation and Rationale

• The evidence-based dose for treating iron deficiency anemia in young children is 3 mg/kg/day of elemental iron 1, 2
• For a 15.2 kg child: 15.2 kg × 3 mg/kg = 45.6 mg elemental iron daily
• With your formulation containing 15 mg elemental iron per mL: 45.6 mg ÷ 15 mg/mL = 3.04 mL daily (can round to 3 mL for practical administration)

Note: Your stated concentration of "15mg iron (75mg)/mL" appears to indicate 15 mg elemental iron per mL, which is the clinically relevant measure for dosing.

Once-Daily Dosing is Equally Effective

• A single daily dose of ferrous sulfate is as effective as divided doses for treating iron deficiency anemia in children 3
• In a randomized controlled trial of 557 anemic children, once-daily dosing (40 mg elemental iron) achieved successful treatment in 61% versus 56% with three-times-daily dosing at the same total dose, with no significant difference 3
• Once-daily dosing may improve adherence compared to multiple daily doses 3

Treatment Duration and Monitoring

• The standard treatment duration is 3 months (12 weeks) for iron deficiency anemia in children 1, 2
• At 3 months, expect mean hemoglobin to increase by approximately 4 g/dL with low-dose ferrous sulfate therapy 1
• If hemoglobin or ferritin levels are not normalized at 3 months, consider extending treatment for an additional 3 months 2
• Monitor hemoglobin, serum ferritin, and complete blood count at baseline and at 3 months 1, 2

Safety and Tolerability Profile

• Low-dose ferrous sulfate (3 mg/kg/day) demonstrates excellent tolerability in young children 1, 2
• Only 4.8% of children experienced drug-related adverse events (primarily mild upper abdominal pain) in a study using 2 mg/kg/day 2
• Gastrointestinal side effects are minimal at this dosing regimen 3, 2
• Diarrhea rates with ferrous sulfate are lower than with iron polysaccharide complex (35% vs 58%) 1

Critical Pitfalls to Avoid

• Do not prescribe higher doses thinking more is better: The 3 mg/kg/day dose is superior to higher doses in terms of tolerability while maintaining efficacy 1, 2
• Ensure accurate measurement: Provide caregivers with a calibrated oral syringe marked in mL increments for precise dosing
• Administer on an empty stomach when possible to maximize absorption, though giving with food is acceptable if gastrointestinal symptoms occur 1
• Do not discontinue treatment prematurely: Even if symptoms improve, complete the full 3-month course to replenish iron stores 2
• Verify the actual elemental iron concentration on your specific product label, as formulations vary

Expected Outcomes

• 95% of children achieve hemoglobin normalization (>11 g/dL) by 3 months with 2-3 mg/kg/day dosing 2
• 84% achieve ferritin normalization (>15 ng/mL) by 3 months 2
• Mean ferritin levels increase from approximately 3 ng/mL to 15.6 ng/mL over 12 weeks 1