Why is the dorsogluteal site not recommended for IM injection in children under 3 years of age?

The dorsogluteal site is not recommended for intramuscular (IM) injections in children under 3 years of age primarily because the muscle in this area is considered underdeveloped in young children. In infants and toddlers, the gluteal muscle is not sufficiently developed to accommodate an effective and safe injection. The risk of injury to surrounding structures, including the sciatic nerve and major blood vessels, is higher in this age group due to the anatomy of their musculature. Moreover, this muscle may not provide a consistent or adequate volume for injections, which could lead to complications or reduced efficacy of the administered medication.

Injections in this area could lead to inadequate absorption of the medication, raising concerns for therapeutic effectiveness. Instead, safer sites such as the vastus lateralis (the thigh) or deltoid muscle areas are preferred, as they are better developed and provide a greater margin of safety for injections in young children.