Fluid requirements and age appropriate formula for infants, children and young people
These guidelines are intended to be used for infants and children, requiring short-term nasogastric feeding, or oral feeds with nasogastric top-ups.
These guidelines are intended to be used for infants, children and young people requiring short-term nasogastric feeding, or oral feeds with nasogastric top-ups. Please refer to a dietitian if enteral feeding is likely to be required longer term or a special feed is needed (something other than breastmilk or standard infant formula). This information does not replace an individualised nutrition assessment by a dietitian.
Exclusions
These guidelines are not intended for patients who are:
Breastfeeding and feeding well
In the Newborn Intensive Care or Paediatric Intensive Care Units
On paediatric oncology hydration fluid protocols
Being treated on the renal transplant fluid protocol
On ketogenic diet therapy
Have known gastrointestinal abnormalities
Transitioning from intravenous nutrition to enteral/oral feeds
Diagnosed with an inborn error of metabolism
Prescribed a specialised or concentrated formula
Cautions
Specialist opinion should always be sought in the following situations:
Preterm
Renal failure (including oliguric, polyuric or anuric)
Endocrine disturbances of biochemistry, diabetes or hyperinsulinism
Suspected inborn errors of metabolism
Faltering growth
Significant enteral fluid restriction
Infants receiving substantial IV fluids, e.g. IV fluid resuscitation
Contraindications to using the gastrointestinal tract
Nil/very minimal intake for more than 5 days and potentially at risk of refeeding syndrome
Recommended initial volumes for infants
Age | Fluid (ml/kg/d) | WHO 50th centile weight (kg) | |
|---|---|---|---|
|
| Boys | Girls |
Day 0-1 | 60 | 3.3 | 3.2 |
Day 2 | 75 |
|
|
Day 3 | 90 | ||
Day 4 | 105 | ||
Day 5 | 120 | ||
Day 6 | 120 | ||
Day 7+ | 150 | ||
0-3 months | 150-200 | 3.3 - 6.4 | 3.2 – 5.8 |
4-6 months | 130-150 | 7.0 - 7.9 | 6.4 - 7.3 |
7-9 months | 120-150 | 8.3 – 8.9 | 7.6 – 8.2 |
10-12 months | 90-110 | 9.2 – 9.6 | 8.5 – 8.9 |
Recommended initial volumes for children and young people
| Age (years) | Male | Female |
|---|---|---|
| 1-3 | 1000 mL | 1000 mL |
| 4-8 | 1200 mL | 1200 mL |
| 9-13 | 1600 mL | 1400 mL |
| 14-18 | 1900 mL | 1600 mL |
Note: additional fluid of up to 30% may be required for some children and young people.
Age appropriate formula
The choice of feed will depend on the clinical requirements of the individual child. The following tables list the range of available feeds.
Infants ≤12 months | Children 1 – 10 years | Children >10 years |
|---|---|---|
S26 Formula (ready to feed) Infatrini Pepti-Junior Gold EleCare EleCare LCP Neocate Gold Neocate Syneo Karicare Soy Monogen AllerPro Syneo 1 AllerPro Syneo 2 Heparon Junior Kindergen Locasol
| Nutrini 1.0 Nutrini Energy 1.5 Nutrini Energy Multifibre 1.5 Nutrini Low Energy Multifibre 0.76 Nutrini Peptisorb 1.0 Nutrini Peptisorb Energy 1.5 EleCare Vanilla Neocate Advance Peptamen Junior Kindergen Heparon Junior Monogen Oral supplements (may be used as bolus feeds) Fortini Fortini Multifibre Pediasure
| Nutrison 1.0 Osmolite 1.0 Nutrison Multifibre 1.0 Jevity 1.0 (Multifibre) Jevity Hi Cal 1.5 (Multifibre) Nutrison Protein Plus 1.25 Nutrison Protein Plus Multifibre 1.28 Nutrison Energy 1.5 Ensure RTH 1.5 Nutrison 800 Complete Multifibre Nutrison Concentrated Two Cal HN Vivonex TEN Kindergen Nutrison Advance Peptisorb Vital HN Fortisip Fortisip Multifibre Ensure Plus Ensure TwoCal HN Renilon Nepro Elemental 028 |
| Metabolic specific formula (for inborn errors of metabolism) | ||
|---|---|---|
| Infants ≤12 months | Children 1 – 10 years | Children >10 years |
Polycal 10% Energivit PKU Anamix Infant MSUD Anamix infant TYR Anamix Infant | Polycal 15% Energivit PKU Anamix Junior MSUD Anamix Junior TYR Anamix Junior Emsogen | Polycal 20% Energivit PKU Lophlex MSUD Lophlex TYR Lophlex Emsogen |