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Paediatric maintenance fluids: Holliday-Segar (4-2-1)

Fluids & paediatrics

The maintenance rate every paediatric prescription starts from. Use isotonic fluid with glucose; hypotonic maintenance fluid causes iatrogenic hyponatraemia.

What you enter

  • Weight (kg or lb)
FORMULA≤10 kg: 4 mL/kg/h; 10–20 kg: 40 + 2 mL/kg/h per kg over 10; >20 kg: 60 + 1 mL/kg/h per kg over 20
SourceHolliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics 1957;19:823-32; NICE NG29 Intravenous fluid therapy in children and young people (2015, updated 2020)ReviewedFormula and thresholds checked against the source on 2026-08-22. If the source updates, this line will say so.