Pediatric Medication Administration

Pediatric dosing is weight-based, calculated in mg/kg/dose or mg/kg/day, because children are not small adults — their body composition, organ maturity, and drug metabolism differ dramatically by age. Every medication administration starts with an accurate daily weight in kilograms (never estimated, never converted from a parent's memory in pounds). Once you calculate the dose, you compare it against the safe dose range for that drug. If the ordered dose exceeds the maximum safe dose per kg, you do not administer — you clarify with the provider. Liquid formulations dominate pediatric dosing; always measure with an oral syringe, never a household spoon. For IM injections in infants, the vastus lateralis is the preferred site due to its larger muscle mass relative to the deltoid; the dorsogluteal is avoided in young children due to underdeveloped gluteal muscles and proximity to the sciatic nerve. IV medications require volume-controlled devices (burettes or syringe pumps) to prevent fluid overload. Developmental stage guides your approach: toddlers need brief, honest explanations right before the procedure; school-age children benefit from choices (which arm, which flavor). Parental presence during administration is encouraged unless the parent declines.