Vitamin C (Ascorbic Acid) in Pediatrics
Key Points
- Essential water-soluble vitamin crucial for growth and development
- Key role in collagen synthesis and immune function
- Potent antioxidant properties
- Body cannot synthesize vitamin C - must be obtained through diet or supplements
Physiological Functions
- Collagen synthesis and wound healing
- Iron absorption enhancement
- Immune system support
- Antioxidant protection
- Neurotransmitter synthesis
- Carnitine synthesis
Clinical Uses
Primary Indications
- Scurvy Prevention and Treatment
- Rare in developed countries
- Risk in restricted diets
- Treatment dose: 100-300mg daily
- Immune Support
- Upper respiratory infections
- Post-surgical recovery
- Chronic disease states
- Iron Deficiency Anemia
- Enhanced iron absorption
- Co-administration with iron supplements
Secondary Applications
- Wound Healing
- Burns
- Post-surgical wounds
- Chronic ulcers
- Environmental Stress
- Physical exercise
- Environmental pollution
- Psychological stress
- Specific Conditions
- Methemoglobinemia
- Lead poisoning
- Tyrosinemia
Available Preparations
Oral Formulations
- Tablets
- Chewable: 100mg, 250mg, 500mg
- Regular: 250mg, 500mg, 1000mg
- Time-release: 500mg, 1000mg
- Liquid Forms
- Drops: 25mg/mL, 50mg/mL
- Syrup: 100mg/5mL, 250mg/5mL
- Effervescent tablets: 250mg, 500mg, 1000mg
- Gummies and Chewables
- Pediatric formulations: 25mg, 50mg, 100mg
- Often combined with other vitamins
Parenteral Preparations
- Injectable Solutions
- Concentrations: 100mg/mL, 250mg/mL
- Used in severe deficiency
- Critical care situations
Dosing Guidelines
Recommended Daily Allowance (RDA)
- 0-6 months: 40mg/day
- 7-12 months: 50mg/day
- 1-3 years: 15mg/day
- 4-8 years: 25mg/day
- 9-13 years: 45mg/day
- 14-18 years: 65-75mg/day
Therapeutic Dosing
- Scurvy Treatment
- Infants: 100-300mg daily in divided doses
- Children: 100-500mg daily in divided doses
- Adolescents: 500-1000mg daily in divided doses
- Upper Respiratory Infections
- 1-3 years: 100-200mg daily
- 4-8 years: 200-400mg daily
- 9-13 years: 400-600mg daily
- 14-18 years: 500-1000mg daily
Special Situations
- Burns: 1000mg daily
- Major surgery: 100-200mg daily
- Critical illness: 200-400mg daily
Deficiency States
Risk Factors
- Malnutrition
- Malabsorption disorders
- Restrictive diets
- Chronic diseases
- Smoking exposure
Clinical Manifestations
- Early Signs
- Fatigue
- Irritability
- Poor wound healing
- Frequent infections
- Late Signs (Scurvy)
- Gingival bleeding
- Petechiae
- Bone pain
- Joint swelling
- Impaired wound healing
Safety & Monitoring
Side Effects
- Common (with high doses)
- Diarrhea
- Abdominal cramps
- Nausea
- Headache
- Less Common
- Kidney stones (in predisposed individuals)
- Iron overload (in hemochromatosis)
- False glucose readings
Monitoring Parameters
- Clinical response
- Dietary intake assessment
- Serum levels (if indicated)
- Urinary oxalate (in kidney stone formers)
Drug Interactions
- Enhanced iron absorption
- May interfere with certain laboratory tests
- Potential interaction with warfarin
- May affect chemotherapy drugs
Further Reading
