The drug atlas
Child Health/Paediatric prescribing principles

Paediatric prescribing & vitamin K

also: weight-based dosing · vitamin K newborn · paracetamol child · avoid aspirin

Overview

The cross-cutting safety rules of prescribing for children — weight-based dosing, age contraindications, and routine newborn vitamin K.

Mechanism

Children are not small adults: dose by weight (mg/kg, capped at the adult dose) and account for immature hepatic/renal handling. Newborn IM vitamin K corrects the physiological deficiency of vitamin-K-dependent clotting factors → prevents vitamin K deficiency bleeding (haemorrhagic disease of the newborn).

Indications

  • Safe paediatric prescribing
  • Routine newborn prophylaxis (vitamin K)

The agents

Vitamin K (phytomenadione)newborn prophylaxis

IM at birth (or oral course)

Prevents VKDB; IM is most reliable.

Paracetamol / ibuprofenanalgesia/antipyretic

weight-based

Ibuprofen avoided in dehydration/varicella caution.

Adverse effects

Dosing errors (10-fold) from weight miscalculationserious

Always check mg/kg and the adult cap.

Excipient/volume issues in neonatescommon

Cautions & contraindications

Aspirin in children <16paediatric

Reye syndrome (except Kawasaki/specific indications).

Tetracyclines <12 yearspaediatric

Teeth staining / bone.

Codeine <12 years (and care in 12–18)paediatric

Variable CYP2D6 metabolism → respiratory depression.

Fluoroquinolonespaediatric

Cartilage/tendon (relative).

Interactions

  • As per individual drugs

Monitoring & kinetics

Weight at each prescription; recalculate as the child grows

Weight-based mg/kg dosing, capped at the adult dose.

Source: BNF for Children — Prescribing in children