Calcium, Phosphate, Potassium and Zinc Supplementation in Neonates and Children.

Updated April 2025 to include information on zinc supplementation

Dear Colleagues,

This position statement is designed to support the safe, consistent administration of enteral calcium, phosphate, potassium and zinc supplementation using a portion of the available, licensed effervescent tablets.  This has been written in response to the fact that there are currently no licensed oral liquid calcium, phosphate, potassium and zinc products available in the UK.
As so often in paediatrics, we have to choose a pragmatic approach and are utilising available licensed dosage forms off label to allow administration of the required dose. In the case of effervescent tablets, this can be particularly error prone and theposition statement provides a practical guide to support this being done as safely as possible.
We would very much welcome the development of licensed oral calcium and phosphate solutions. In the meantime, however, I hope the information provided here will serve as a useful guide.

Best wishes, Nanna Christiansen, Chair, NPPG

Additional resources are available to support the implementation of recommendations within this Position Statement: