Pediatric Blood-Volume Limits and Newborn Screening
Estimate the child's total blood volume from weight, keep the day's draws within the facility's percentage limit (guidelines range 1% to 5% per 24 hours), and collect newborn screening spots at 24 to 48 hours of age on an in-date card.
Blood volume estimates and limits
| item | value | source |
|---|---|---|
| Total blood volume, adult | 65 to 70 mL/kg | Korean guideline 2025 |
| Total blood volume, child | 75 to 80 mL/kg | Korean guideline 2025; Howie 2011 (WHO Bulletin) |
| Total blood volume, healthy newborn | About 85 mL/kg (rising to about 105 mL/kg by the end of the first month) | Korean guideline 2025; Howie 2011 |
| Total blood volume, preterm infant | About 100 mL/kg | Korean guideline 2025 |
| Limit per 24 hours (published guidelines) | 1% to 5% of total blood volume | Howie 2011; Korean guideline 2025 |
| Cumulative limit | Up to 10% of total blood volume over 8 weeks | Howie 2011 |
| Sick children (suggested) | No more than 3 mL/kg in 24 hours after the newborn period (about 3.8% of total blood volume) | Howie 2011 |
| Institution example | No more than 2.5% of total blood volume in one draw (chart covering a 24-hour period) | Eastern Health procedure |
Limits vary by institution and were written mostly for research sampling: use your facility's chart. Count every draw in the period, not just the current order.
The Korean guideline words its 10% limit as applying to infants under 8 weeks of age; the WHO Bulletin review (Howie 2011) gives up to 10% over an 8-week period.
If an order would exceed the limit, hold the draw and contact the ordering provider; collect only what is authorized and document (Eastern Health procedure).
Preview only. The full sheet also covers: Worked example; Newborn screening: timing and card information; Collecting the blood spots (heel).
Sources
- Howie SRC. Blood sample volumes in child health research: review of safe limits. Bull World Health Organ 2011;89(1):46-53 · World Health Organization via PubMed Central
- Chang J, et al. Standards and Practice Guidelines for Venous Blood Collection: Consensus Recommendations from the Korean Society for Laboratory Medicine. Ann Lab Med 2025;45(4):343-357 (PMC12187494) · Annals of Laboratory Medicine via PubMed Central
- Collection of Blood Culture Specimens, SOP 6972 v4.0 (effective 2021-05-13), including the paediatric maximum blood draw chart; Eastern Health Laboratory Medicine, Newfoundland and Labrador (institutional procedure, used as an example) · Eastern Health Laboratory Medicine
- Newborn Screening Information for Providers: Blood Spot Collection · Minnesota Department of Health
- Newborn Screening Blood Specimen Collection and Handling Procedure (rev. 1/2020) · Minnesota Department of Health
- How to Fill Out Newborn Screening Cards (rev. 02/2025) · Minnesota Department of Health
- How to Complete Iowa Newborn Screening Cards (May 2017) · State Hygienic Laboratory at the University of Iowa
- Newborn Screening - Specimen Collection Requirements · Texas Department of State Health Services
- NBS Specimen Collection - Special Circumstances · Texas Department of State Health Services
- Alternative Methods for Collecting a Newborn Screen · Texas Department of State Health Services
- Phenylketonuria (MedlinePlus Genetics) · National Library of Medicine (MedlinePlus)
- Galactosemia (MedlinePlus Genetics) · National Library of Medicine (MedlinePlus)
Free Special Collections practice questions
- Question 1A blood culture order notes that fungemia due to yeast is suspected. Under IDSA/ASM guidance, which bottle combination may the lab ask for in at…
- Question 2Blood is drawn by syringe for blood cultures and a lavender-top tube. Using a transfer device, which is filled first?
- Question 3A donor's blood flow is well established 40 seconds after the needle enters the vein, with the blood pressure cuff still inflated. What does WHO say…