Pediatric Nutrition

To supplement our new pediatric reference cards, I've included some things in this e-mail which were not covered.

Weight Gain

  • Proper weight gain is 25-30 grams/day for first 4-6 months.

  • After 4-6 months patients should double their birth weight.

  • Patients regain birth weight by 10-14 days.

Pediatric Fluid Resuscitation

  • Bolus: 20mL/kg

    • Remember, in sepsis can do 3x bolus = 60 mL/kg

  • Maintenance Fluids - The 4-2-1 rule

    • Add the following for each 10kg of body weight:

    • 4mL/kg

    • 2mL/kg

    • 1mL/kg

    • e.g. 24 kg child = (4mL*10mL/kg) + (2mL*10mL/kg) + (1mL*4mL/kg) = 64 mL/kg

Pediatric Dextrose/Hypoglycemia Resuscitation

  • The dextrose Rule of 50

    • Multiple your % dextrose solution supplied in ED by the ml/kg to give to patient to give and set equal to 50

    • In other words, divide 50 by the % dextrose solution you have available

    • For D10: 10X=50 i.e. give 5mL/kg of D10

    • For D25: 25X=50 i.e. give 2mL/kg of D25

    • For D50: 50X=50 i.e. give 1mL/kg of D50

Pediatric wet diaper output

  • Proper output is 1-2ml/kg/hr

  • Practically, patients should have 4-6 wet diapers per day.

    • Remember to base this off patient's "normal" as some parents do not change diapers as often.