The BNF for Children provides information on the use of medicines in children ranging from neonates (including preterm neonates) to adolescents. The terms infant, child, and adolescent are not used consistently in the literature; to avoid ambiguity actual ages are used in the dose statements in BNF for Children. The term neonate is used to describe a newborn infant aged 0–28 days. The terms child or children are used generically to describe the entire range from infant to adolescent in BNF for Children.

BNF for Children is divided into the following broad areas.

General guidance

The section on general guidance includes general advice on the use of medicines for managing childhood conditions. It also includes information on prescribing controlled drugs and the management of palliative care. Advice is given on the reporting of adverse reactions. General principles on the use of medicines in hepatic impairment, renal impairment, pregnancy, and breast-feeding are also included in this section.

Notes on conditions, drugs and preparations

The main text consists of classified notes on clinical conditions, drugs and preparations. These notes are divided into 15 chapters, each of which is related to a particular system of the body or to an aspect of neonatal and paediatric medical care. Each chapter is then divided into sections which begin with notes on the selection and use of medicines. Guidance on dental and oral conditions is identified by means of a relevant heading (e.g. Dental and Orofacial pain) in the appropriate sections. The notes are followed by details of relevant drugs and preparations.

Drug entries

Drugs appear under pharmacopoeial or other non-proprietary titles. When there is an appropriate current monograph (Medicines Act 1968, Section 65) preference is given to a name at the head of that monograph; otherwise a British Approved Name (BAN), if available, is used. Information on the properties of each drug is organised as shown in the illustration below; the information on cautions, contra-indications, side-effects, dose and indications reflects, as far as possible, the manufacturer's summary of product characteristics.

Side-effects are generally listed in order of frequency and arranged broadly by body systems. Occasionally a rare side-effect might be listed first if it is considered to be particularly important because of its seriousness.

For the majority of drugs, doses are expressed in terms of body-weight (i.e. standardised by weight). To calculate the dose for a given child the weight-standardised dose is multiplied by the child's weight (or occasionally by the child's ideal body-weight). The calculated dose should not normally exceed the maximum recommended dose for an adult. For example if the dose is 8mg/kg (max. 300mg) a child of 10kg bodyweight should receive 80mg but a child of 40kg body-weight should receive 300mg (rather than 320mg).

Doses are expressed for specific age ranges; neonatal doses are preceded by the word Neonate, all other doses are preceded by the word Child. Age ranges in the BNF for Children are described as follows:
Child 1 month–4 years refers to a child from 1 month old up to their 4th birthday;
Child 4–10 years refers to a child from the day of their 4th birthday up to their 10th birthday.

However, a pragmatic approach should be applied to these cut-off points depending on the child's physiological development, condition, and if weight is appropriate for the child's age.

The symbol is used to denote those preparations considered to be less suitable for prescribing. Although such preparations may not be considered as drugs of first choice, their use may be justifiable in certain circumstances.

Preparations

Preparations usually follow immediately after the drug which is their main ingredient.

Preparations are included under a non-proprietary title, if they are marketed under such a title, if they are not otherwise prescribable under the NHS, or if they may be prepared extemporaneously.

If proprietary preparations are of a distinctive colour this is stated.

In the case of compound preparations the indications, cautions, contra-indications, side-effects, and interactions of all constituents should be taken into account for prescribing.

When no suitable licensed preparation is available details of preparations that may be imported or formulations available as manufactured specials or extemporaneous preparations are included.

Prescription-only medicines

This symbol has been placed against those preparations that are available only on a prescription given by an appropriate practitioner.

The symbol indicates that the preparation is subject to the prescription requirements of the Misuse of Drugs Act. For advice on prescribing such preparations see Prescribing Controlled Drugs.

Preparations not available for NHS prescription

This symbol has been placed against preparations that are not prescribable under the NHS. Those prescribable only for specific disorders have a footnote specifying the condition(s) for which the preparation remains available. Some preparations which are not prescribable by brand name under the NHS may nevertheless be dispensed using the brand name provided that the prescription shows an appropriate non-proprietary name.

Prices

Prices have been calculated from the basic cost used in pricing NHS prescriptions. The price for an extemporaneously prepared preparation has been omitted where the net cost of the ingredients used to make it would give a misleadingly low impression of the final price. Since the prices shown in the BNF for Children do not include professional fees and overhead allowances, they are not suitable for quoting to patients seeking private prescriptions or contemplating over-the-counter purchase. See also Prices in the BNF for Children for more details.

Emergency treatment of poisoning

This chapter provides information on the management of acute poisoning when first seen, although aspects of hospital-based treatment are mentioned.

Appendixes and indexes

The appendixes include information on interactions, borderline substances, and cautionary and advisory labels for dispensed medicines. They are designed for use in association with the main body of the text.

The Dental Practitioners' List and the Nurse Prescribers' List are also included in this section. The indexes consist of the Index of Manufacturers and the Main Index.

 

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