Prescribing for children requires a nuanced approach due to the complex physiological and developmental factors that differentiate children from adults. Neonates exhibit immature organ systems, influencing drug absorption, metabolism, and renal clearance. Factors such as high gastric pH, delayed gastric emptying, and low plasma protein levels can significantly alter drug bioavailability and risk of toxicity. Renal immaturity in neonates necessitates adjusted dosing intervals for drugs, such as gentamicin, to mitigate toxicity. Prescribers must consider unlicensed or off-label drug use in paediatrics, balancing clinical evidence, safety, and informed parental consent.