Dear Doctor Column, February 27, 2006
Childhood Poisonings: Prevention and Treatment
Question:
My sister-in-law noticed that I keep syrup of ipecac in the medicine cabinet in case my 2-year-old accidentally eats or drinks something poisonous; this is recommended by several of my parenting books. She says the advice is outdated and I should throw the ipecac away. Who’s right?
Answer:
Your sister-in-law is correct. Parents should no longer give syrup of ipecac to children or keep it in the home, according to the American Academy of Pediatrics (AAP), which, in 2003, reversed their long-standing recommendation that parents keep the substance on hand. Ipecac induces vomiting, which would seem a logical response when a child has ingested a poisonous substance, but scientific evidence has failed to show children treated with ipecac reap any benefits. Even when ipecac is administered immediately after a child consumes a poisonous substance, vomiting does not completely remove the toxin from the stomach.
Most Emergency Departments have long since stopped treating children with syrup of ipecac in favor of more effective activated charcoal, which binds to poison in the stomach and prevents it from entering the bloodstream. Occasionally, parents accidentally give their children too much ipecac, which can cause continued vomiting that may prevent or interfere with activated charcoal treatment. AAP recommends parents dispose of any syrup of ipecac they have in a safe manner.
Children like to put things in their mouths and unintentional poisonings are common; in 2005, the American Association of Poison Control Centers reported more than 1 million such events in children younger than 6 years. However, very few of these poisonings resulted in deaths.
If your child ingests a potentially poisonous substance, it is crucial to immediately call the Poison Help Line at 1-800-222-1212. This nationwide toll-free number will connect you with a poison expert in your area 24 hours a day, 7 days a week. If your child is having convulsions or has collapsed or stopped breathing, call 911 for emergency transport to the hospital.
Prevention is the best protection against accidental childhood poisonings. For young children, the most dangerous potential poisons in the home are:
- Medicines: iron-containing supplements, opioid pain relievers, and high blood pressure medications are the leading cause of poisoning deaths in children younger than 5 years, but many other medications, such as antidepressants and over-the-counter decongestants, can be lethal to children.
- Cleaning products
- Antifreeze
- Windshield washer fluid
- Pesticides
- Furniture polish
- Gasoline, kerosene, lamp oil
Source: AAP
The Consumer Products and Safety Commission offers these tips to help prevent childhood poisonings:
- Keep medicines and household or automotive products locked out of sight and out of your child’s reach.
- Keep all medication and household products in their original packaging with all labeling intact.
- Always reseal child-resistant packaging immediately and keep your bathroom cabinet free of unused or out-of-date medications.
- Watch your child closely when you are in a home where medicines or household products may not be safely stored.
- Keep a close watch on children when you are using potentially dangerous products.
- Keep decorative lamps and candles that contain lamp oil out of your child’s reach.
- Always leave the lights on when giving or taking medicine, checking the dose every time.
- Avoid taking medicine in front of children and always call it “medicine,” never “candy” or any other euphemism.
- Childproofing your home also includes the garage, basement, storage shed, or any other area where you might keep potentially hazardous substances.
For more information about preventing poisonings and other childhood injuries, visit AAP’s Injury Prevention Program. The site offers age-related safety fact sheets covering a variety of topics.