Fer-In-Sol Dosage for 14-Month-Old Infant
For a 14-month-old weighing 12.5 kg with iron deficiency anemia, administer 3 mg/kg/day of elemental iron (approximately 37.5 mg or 2.5 mL of Fer-In-Sol drops), given once daily between meals.
Treatment Dosing
- The CDC recommends 3 mg/kg/day of elemental iron for treating presumptive iron deficiency anemia in infants and young children 1, 2
- For this 12.5 kg infant, this equals approximately 37.5 mg of elemental iron daily 1
- Fer-In-Sol drops contain 15 mg elemental iron per mL, so the dose would be approximately 2.5 mL once daily 1
Administration Guidelines
- Administer between meals (on an empty stomach) to maximize iron absorption, though this may increase gastrointestinal side effects 1, 2
- Give with vitamin C-rich foods or juice to enhance absorption 1, 2, 3
- Avoid giving with cow's milk, which inhibits iron absorption 2, 3
Once-Daily Dosing is Effective
- A single daily dose is as effective as divided doses and improves adherence 4
- Recent high-quality evidence demonstrates that 3 mg/kg/day given once daily achieves similar hemoglobin increases as divided dosing 5, 4
- Ferrous sulfate is superior to iron polymaltose complex, producing a 1.0 g/dL greater hemoglobin increase at 12 weeks 5
Treatment Duration and Monitoring
- Continue treatment for 3 months total: until hemoglobin normalizes plus an additional 2 months to replenish iron stores 2, 3
- Recheck hemoglobin after 4 weeks of treatment 1, 2
- An increase of ≥1 g/dL in hemoglobin or ≥3% in hematocrit confirms iron deficiency anemia and indicates the treatment is working 1
- If no response after 4 weeks despite compliance, further evaluate with MCV, RDW, and serum ferritin to rule out other causes 1
Common Pitfalls to Avoid
- Do not exceed 24 oz (720 mL) of cow's milk daily, as excessive milk consumption is a leading cause of iron deficiency in this age group 2, 3
- Side effects are generally mild with ferrous sulfate at this dose; diarrhea occurs less frequently than with iron polymaltose complex 5, 6
- Ensure dietary counseling addresses the underlying cause of low iron intake 1