At some point most of us involved in any way with children have asked this question. I am a mom, grand mom and nurse and I can remember a time when I didn’t know the answer to that question.
How much Acetaminophen do you give your child? For a child without complex medical problems the answer is 10 mg of Acetaminophen for every kilogram of body weight every 4 hours or 15 mg every 6 hours. For this purpose, I will use 10 mg/kg every 4 hours. If you prefer an already calculated dose and/or more information let me explain.
A kilogram is 2.2 pounds so if your child weighs 22 pounds that is 10 kg. This means that your 22 pound child needs 100 mg of acetaminophen. Pounds divided by 2.2 equals kilograms then multiply by 10 to get your acetaminophen dose by weight.
The Formula looks like: Pounds :-: 2.2 = Kilograms x 10 = dose in mg.
Acetaminophen dose is 160 mg in 5 ml so every 1 ml equals 32 mg.
With this information and your child’s weight you can calculate your child’s acetaminophen dosage. If you prefer a ready made chart with this information I have done the calculations for you.
| Weight of your Child in Pounds (undressed) | Acetaminophen Dosage in ml of 160 mg/5 ml | Chewable Acetaminophen Tablets | Acetaminophen 80 mg Rectal Suppository. |
| 3 pounds 8 ounces | 0.5 ml | ||
| 5 pounds 4 ounces | 0.75 ml | ||
| 7 pounds | 1 ml | ||
| 8 pounds 8 ounces | 1.25 ml | ||
| 10.5 pounds | 1.5 ml | ||
| 12.5 pounds | 1.75 ml | ||
| 14 pounds | 2 ml | ||
| 16 pounds | 2.25 ml | ||
| 18 pounds | 2.5 ml | 80 mg | 1 suppository |
| 19.5 pounds | 2.75 ml | 1 | |
| 21 pounds | 3 ml | 1 | |
| 23 pounds | 3.25 ml | 1 | |
| 24.5 pounds | 3.5 ml | 1 | |
| 26.5 pounds | 3.75 ml | 1 | |
| 28 pounds | 4 ml | 1 | |
| 30 pounds | 4.25 ml | 1 | |
| 32 pounds | 4.5 ml | 1 | |
| 33.5 pounds | 4.75 ml | 1 | |
| 35 pounds | 5 ml | 160 mg | 2 suppositories |
| 39 pounds | 5.5 ml | 2 | |
| 42 pounds | 6 ml | 2 | |
| 46 pounds | 6.5 ml | 2 | |
| 49 pounds | 7 ml | 2 | |
| 53 pounds | 7.5 ml | 240 mg | 3 suppositories |
Should you use age or weight to dose Acetaminophen?
On many tables for giving Acetaminophen you will see to give a certain dose for a certain age or weight. Sometimes as parents it is confusing especially if your child weighs at one dose but is in the dose range for a different age. The proper solution for this is that weight is the more accurate way to dose any medication for a child.
How old does my child need to be to get acetaminophen?
While acetaminophen can be safely given to newborns this is definitely not recommended. Fever or pain in an infant especially under one month old should be evaluated by a physician. A temperature of 100.4 rectal especially when accompanied with irritability in a newborn to a few months old should be evaluated by a pediatrician. Babies can be warm when bundled, so I always unwrapped mine and rechecked their temperature just to confirm that what they had was a fever and not an overly zealous mother who thought they were cold.
Most infants receive their first dose of acetaminophen when they receive their 2 month immunizations. DTaP vaccine while imperative to prevent pertussis can sometimes cause soreness and fever. Acetaminophen is often given to help with these symptoms. Your doctor can give the recommended dose for your baby when they give the immunizations.
Just as a side note here, Acetaminophen is safe under medical direction in babies. Pediatricians however do not recommend that ibuprofen be given until a child is over 6 months old. Both Acetaminophen and Ibuprofen are great medications for fever and pain but ibuprofen should not be given until a child is at least 6 months old. Unless prescribed by a physician for a specific medical condition Aspirin is not recommended for children at any age unless there is another medical condition warranting the use of Aspirin.
How to prevent unintentional overdose in your child
While it is important to know your child’s acetaminophen dose, it is also important to know a few other tips to keep your child safe as it relates to this medication. Because an overdose is a possibility with any medication it is important to keep accurate count that you are giving your child the right dose and the correct time between doses. In our house we kept a notebook beside the medication bottle and jotted down anytime we gave medications so that mom and dad did not give a dose each without knowing that the other had given one.
Avoid giving your child too much medication by using single ingredient medications. Acetaminophen is found in many other medications so you would not want to give two medications that both have the same drug in them. You can prevent this by either giving only one medication or carefully reading the ingredients. I recommend only one medication because many medications go by more than one name.
Make sure all medications are locked up or have child proof caps. As children grow they have a natural curiosity about things that open and close. Encourage the curiosity but prevent an accidental overdose by securing all medication.
In recent years all forms of liquid acetaminophen have been standardized in dose to 160mg/5ml. This has done a lot to help prevent overdoses related to differences in concentrations between infant drops and acetaminophen elixir. Yes, this does mean you can use the bigger bottle and probably save yourself a little money. They really are the same strength. Chewable tablets can be given when a child is old enough to chew a tablet and at the proper weight for that dosage. Acetaminophen suppositories can be used in the correct dosage but they should only be given as a whole suppository since the concentration of medication is not equally dispersed through the suppository and cutting it could result in giving too much or too little medication.
Children should always be given a pediatric formulation until they are at the correct weight to be able to take an adult formulation.
Sometimes it is easy to speak of medications as yummy and good and even compare them to candy. It is important to always say medication is medicine and give clear signals to your child that it is used for the purpose of helping them feel better when they are hurting or sick not that it is candy.
Sometimes as parents when our child has a high fever it is tempting to give more acetaminophen when their temperatures don’t come down like we think they should. It is important to understand that fever is the bodies way of fighting foreign invaders like bacteria and viruses. Helping keep your child comfortable is important but most of the time fever is much less harmful than too much medication. If fever does not respond to Acetaminophen or when recommended Ibuprofen, uncovering your child or a tepid bath are none medicinal ways of controlling fever.
What to do if you think your child has had too much Acetaminophen
If you are ever concerned about a possible acetaminophen overdose or notice early signs or symptoms of an overdose such as nausea, vomiting, lethargy and abdominal pain, call a poison control center at 800-222-1222 in the United States or seek emergency care.
Why is acetaminophen used?
Acetaminophen is used to treat pain and fever. It is a very effective medication for both. As with all medications(and just about anything else you take into your body) it does have side effects. Acetaminophen at the correct dose rarely causes problems but in higher doses it can cause liver damage. This is why it is important to correctly dose this medication. Acetaminophen should be given no more than every 4 hours and no more than 5 doses in 24 hours. It should not ever be given to a child with liver problems.
There is nothing more precious to a parent than their child. This is meant to be helpful information and good guidance when using a commonly used medication. Always follow your child’s pediatricians recommendations and ask questions if there is something you don’t understand. You are your child’s voice. Always store medications in a secure area.