What is the appropriate acetaminophen (paracetamol) dose for a newborn weighing 3.799 kg?

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Acetaminophen Dosing for a 3.799 kg Newborn

For a newborn weighing 3.799 kg, administer acetaminophen 10-15 mg/kg per dose every 4-6 hours as needed, which equals 38-57 mg per dose, with a maximum of 5 doses per 24 hours not exceeding 75 mg/kg/day (approximately 285 mg/day total). 1

Weight-Based Dose Calculation

  • The precise calculation for this 3.799 kg newborn is:

    • Minimum dose: 3.799 kg × 10 mg/kg = 38 mg per dose 1
    • Maximum dose: 3.799 kg × 15 mg/kg = 57 mg per dose 1
    • Maximum daily dose: 3.799 kg × 75 mg/kg = 285 mg per day 1
  • Practical dosing recommendation: Give 40-55 mg per dose for ease of measurement with standard infant formulations 1

Dosing Interval and Frequency

  • Administer every 4-6 hours as needed for fever or pain 1
  • Minimum interval between doses must be 4 hours 1
  • Maximum of 4-5 doses in 24 hours 1

Formulation and Administration

  • Acetaminophen infant drops typically come as 80 mg/0.8 mL (100 mg/mL) or 160 mg/5 mL (32 mg/mL) syrup 1
  • For 80 mg/0.8 mL drops: Give 0.32-0.44 mL per dose (40-55 mg) 1
  • For 160 mg/5 mL syrup: Give 1.25-1.7 mL per dose (40-54 mg) 1
  • Always use the calibrated dropper or syringe provided with the product to ensure accurate dosing 1

Critical Safety Parameters

  • Never exceed 15 mg/kg per single dose (57 mg for this infant) 1
  • Never exceed 75 mg/kg/day total daily dose (285 mg/day for this infant) 1
  • Never give doses more frequently than every 4 hours 1
  • Acetaminophen overdose can cause severe hepatotoxicity and acute liver failure, even in infants, making strict adherence to dosing limits essential 2, 3

Common Pitfalls to Avoid

  • Do not confuse infant drops (80 mg/0.8 mL) with children's syrup (160 mg/5 mL) - this concentration difference has led to serious overdoses 1
  • Do not combine multiple acetaminophen-containing products without accounting for total daily dose 3
  • Ensure parents understand the maximum daily dose - repeated supratherapeutic dosing over days can cause hepatotoxicity even when individual doses seem appropriate 2, 3

Practical Prescribing Example

Prescription: Acetaminophen infant drops 80 mg/0.8 mL

  • Dose: 0.4 mL (40 mg) every 4-6 hours as needed for fever or pain 1
  • Maximum: 5 doses in 24 hours 1
  • Instructions: Measure dose carefully with provided dropper; never exceed recommended dose; maintain at least 4 hours between doses 1

References

Guideline

Paracetamol Dosing Guidelines for Infants

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Acetaminophen Poisoning.

Critical care clinics, 2021

Research

Evaluation and treatment of acetaminophen toxicity.

Advances in pharmacology (San Diego, Calif.), 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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