Newborn babies grow quickly and sick neonates often stay for lengthy periods of time in the NICU.  As medications administered in the NICU are dosed on a per kilogram basis, medication dosages must frequently be adjusted for weight gain during an infant’s hospital stay.

            On Tuesdays when calculating growth rates, housestaff or NNPs should review the infant’s medication administration record ensuring that it is complete, up-to-date, and that dosages of respective drugs are still in the therapeutic range given any change in the infant’s weight.

            Medication dosages should not be changed unless adjusting for the infant’s new weight changes the dose by > 20%.  Smaller dosage changes are often clinically insignificant and only add to the pharmacy’s workload, the potential for human error, and ultimately the infant’s medical bill.

            Vitamin A should continue to be adjusted weekly in 250 IU increments based on weight without regard to the percentage of change in dose.

Approved at the Nursery Policy & Procedure meeting 4/17/02.