Poisoning in Babies: Causes, Treatments & Prevention

Written Dr. Seran Kim, board-certified Emergency Physician

As if parents didn’t have enough to worry about, accidental poisonings are unfortunately a common occurrence. Every day, over 300 children are treated in the Emergency Department, and two children die in the United States, as a result of some form of poisoning. The good news is that most childhood poisonings are accidental, and with proper precautions, are highly preventable.

• What is poisoning?
• What are common types of poisoning?
• What are treatments for poisoning?
• When to call 911 for poisoning
• How to prevent poisoning in babies and children

What is poisoning?

A poison is any substance that can cause illness, injury or death. Poisoning can occur if this substance is swallowed, inhaled or absorbed through the skin. Some poisons are toxic in small doses, but others are harmless substances that can become poisonous if encountered in large enough quantities. A poisoning can occur in almost any setting, from any substance and in any form (liquid, solid or gas).

What are common types of poisoning?

Childhood exposures often occur due to exploratory behavior. There are many everyday substances that, even in small amounts, can result in serious injury or death. The main culprits of unintentional poisoning in children are:

Medications

Medications are the leading cause of accidental poisoning deaths in children. It can happen if a child ingests medications found in the home, or if a parent accidentally gives a child more than the correct dosage. And it’s not only prescription drugs that we worry about. Even over-the-counter medications, dietary supplements, homeopathics (e.g. tea tree oil), herbals and vitamins (e.g. iron) can be dangerous for young children.

Some common examples include analgesics (e.g. acetaminophen, aspirin), prescription antidepressants, cardiovascular medications (e.g. digoxin), blood thinners (e.g. warfarin), blood pressure medications (e.g. metoprolol, verapamil), sleeping aids (e.g. zolpidem), opioid narcotics (e.g. fentanyl) and antihistamines (e.g. diphenhydramine).

Note that not all concerning medications have to be in pill or syrup form. Other forms include skin patches, injectables and eye drops.

Symptoms depend on the substance ingested, but the most telltale signs of a medication overdose in a child are vomiting, diarrhea and/or drooling. Other symptoms include profuse sweating, abdominal pain, dilated or pinpoint pupils, slurred speech, yellowing of skin or eyes, dizziness or seizures.

Household products

Poisoning can occur from the ingestion or inhalation of ubiquitous household substances. These include bleach, shower/toilet bowl cleaners, laundry or dishwasher detergent pods, pesticides, insecticides, paint thinners, oven cleaners, drain clog removers and even glue. These items are notorious for damaging a child’s gastrointestinal tract and/or airway when ingested. Some of these items also have the potential to harm skin or eyes with direct contact.

Symptoms vary depending on the product ingested but can include severe burns to the mouth/throat/stomach, bloody stool or vomit, abdominal pain, confusion, loss of consciousness and convulsions.

Carbon monoxide

Carbon monoxide (CO) is a colorless, odorous, poisonous gas that is emitted from fuel-burning appliances that are not functioning properly or are not well-vented, such as gas ranges/ovens, furnaces, space heaters, clothes dryers, gas water heaters, portable generators, wood-burning fireplaces and stoves, as well as cars. Even in small quantities, carbon monoxide can cause permanent neurologic damage or death.

Early symptoms include dull headache, weakness, dizziness, nausea or vomiting, shortness of breath, confusion, blurry vision and loss of consciousness.

Household plants

Many common indoor and outdoor house plants contain toxins and, when ingested, can cause symptoms ranging from throat irritation, nausea, vomiting or diarrhea to blistering skin, difficulty breathing, delirium, convulsions or even death.

The most common plants that are accidentally ingested by children include daffodils, dumb cane, caladium, philodendron, pothos, foxglove, hydrangea, lilies, oleanders, rhododendrons, wisteria, English ivy and snake plants.

Alcohol, nicotine and illicit substances

Alcohol intoxication can occur when children accidentally ingest alcoholic beverages such as wine, beer or liquor. Alcohol is also found in perfume, mouthwash, cleaning products and hand sanitizers as well as over-the-counter cold medications. In young children, alcohol poisoning symptoms can include low blood sugars, which can lead to loss of consciousness, convulsions and coma.

Nicotine, which is found in cigarettes, cigars, chewing tobacco and nicotine gum, can also cause poisoning when ingested by small children. E-cigarettes (which contain liquid nicotine) and nicotine patches can be poisonous if contents are ingested or come into direct contact with the skin. Symptoms of nicotine poisoning include nausea and vomiting, difficulty breathing, cardiac arrhythmia or seizures.

Poisoning from other illicit substances, such as cocaine, methamphetamine, ecstasy, synthetic cannabinoids (known as synthetic marijuana, K2 or spice) or synthetic cathinones (found in bath salts) can also cause irreparable harm when ingested. Symptoms include inconsolable crying/irritability, slowed breathing, elevated heart rate, chest pain, loss of consciousness and seizures.

Hydrocarbons

Hydrocarbons are a family of organic chemical substances that include gasoline, kerosene, lamp oil, lighter fluid, paint thinners or removers and motor oil. Poisoning occurs when these toxins are ingested (more common with younger children) or inhaled. While not seemingly attractive substances to taste, hydrocarbons can be ingested by curious toddlers and aspirated, causing pneumonitis, or an inflammation of the lungs. Hydrocarbons can also be absorbed systemically and cause central nervous system or liver toxicity when ingested in large amounts. The inhalation of hydrocarbons is more common in older children and adolescents and can cause dangerous heart arrhythmias.

Batteries

Batteries contain alkaline electrolytes and are found in many common household items such as watches, calculators, remote controls, flashlights, hearing aids, key fobs and toys. Young children may be tempted to swallow these common objects, especially round, coin-sized “button” batteries, which are particularly dangerous. Button batteries possess a strong electrical charge when out of the electrical unit. When swallowed, they become lodged in a child’s upper esophagus, where they erode the tissue, causing life-threatening damage in less than two hours.

Personal care products

Cosmetics and personal care products are the most common substances implicated in pediatric poisonings. These items, including powders, lotions, perfumes and makeup, are used frequently, which makes them easily accessible. Small children may be attracted to the pleasant smell of these products, assuming that they must taste good too.

Perfumes, colognes, aftershave, facial cleansers, hair tonics and mouthwash are particularly dangerous for children to ingest, as many of these products contain over 50% ethanol alcohol. Even small amounts of alcohol can have dangerous effects on small children, due in part to their smaller body mass and differences in metabolism. This can lead to disturbances in breathing, heart rate and temperature and lower blood sugars, which can cause seizures, coma and death. Beware that these products often contain as much alcohol as alcoholic beverages.

Hair color, permanents and relaxers are also dangerous in small amounts (even those without lye) and can cause severe vomiting and burns to the esophagus and stomach.

Nail products, including nail polish, nail glue and nail remover, may contain acetone, which if ingested in large quantities mimics the symptoms of alcohol poisoning. Also, some artificial nail glue removers contain a chemical that is similar to cyanide and causes seizures, loss of consciousness and cardiac arrest. Lastly, nail primers are highly acidic and can cause immediate, internal burn symptoms on the skin and in the mouth.

What are treatments for poisoning?

Most of the time, a poisoning encounter is witnessed, and your child may subsequently have a sore throat, difficulty breathing, drowsiness, nausea/vomiting and stomach pain or lip/mouth burns. However, some encounters aren’t witnessed, and you need to have a high level of suspicion if your child has other signs, such as a strange smell on their breath, atypical drooling or unusual stains on their clothes.

Poison control should always be contacted, no matter how minor the poisoning initially seems. Their number, 800-222-1222, should be programmed into your phone and written down somewhere obvious in your house for other caregivers. Poison control also has a website tool to get help online. Both options are free, confidential and available 24 hours a day, seven days a week.

The actual treatment protocol ultimately depends on the poison substance and the route of exposure.

Poison that is swallowed

If you witness your child swallowing a poison, or you find your child with an open or empty container of a toxic substance:

• Immediately take the poison away.
• If the substance is still in your child’s mouth, remove it with your fingers, or if the child is older, try to make your child spit it out voluntarily.
• Do not induce vomiting.
• Do not follow any packaging instructions regarding poisoning, as these are often outdated.
• Call poison control. Be sure to keep any packaging handy, including the list of ingredients or prescription bottle.

Poison on the skin

If your child spills a chemical on their body:

• Immediately remove any contaminated clothing, being careful to limit your own contact.
• Rinse their skin with lukewarm (not hot) water.
• If their skin shows signs of burns, continue rinsing for 15 minutes.
• Call poison control for further instructions.
• Do not put butter, grease or ointments on the affected area.

Poison in the eyes

If your child splashes poison into their eyes:

• Flush out their eye(s) with lukewarm (not hot) water, aiming at the inner corner of the eye closest to the nose and letting it run across the eye. Hold the eye open with your fingers. Continue flushing for at least 15 minutes. You may need assistance if you’re holding your child under the sink.
• Call poison control for further instructions.
• Do not put ointment, eye drops or an eye patch on the eye unless instructed to do so.

Poison that’s breathed in

If your child breathes in poisonous vapors or gases (such as from a running car in a closed garage, leaky gas vents or strong fumes from cleaners or solvents):

• Immediately take your child outside to fresh air.
• Once your child breathes without any difficulty, call poison control for further instructions.

When to call 911 for poisoning

• Call 911 if your child has difficulty breathing, seizures or loss of consciousness.
• If your child has stopped breathing, immediately start Cardiopulmonary Resuscitation (CPR).
• Continue CPR until your child starts to breathe on their own again, or someone else can take over.
• If you are alone, continue CPR for 2 minutes before calling 911, or have someone else call right away.

How to prevent poisoning in babies and children

As with most accidents, the key to poisoning is prevention. Poisoning is almost always preventable. The following tips can help you, your family and friends avoid unintentional poisonings:

• Keep all drugs in medicine cabinets or other childproof cabinets that young children can’t access. Don’t forget that herbals, vitamins and homeopathic medicines count as potential poisons.
• Keep cleaning supplies and laundry/dishwashing pods out of reach of children.
• Keep chemical products in their original bottles or containers.
• Don’t use food containers like cups, bottles or jars to store chemical products, such as cleaning solutions or beauty products.
• Have heating systems, water heaters and all other gas-burning appliances serviced by a qualified technician every year.
• Install battery-operated carbon monoxide detectors in your home, and check or replace batteries when changing the time on clocks each spring and fall.
• Never leave a car running inside a garage, even if the garage door is left open.
• Don’t use a stove or fireplace that is not vented to the outside.
• Don’t use a generator, charcoal grill, camp stove or other gasoline- or charcoal-burning device inside the home.
• Keep houseplants off the floor and out of reach.
• Keep alcohol and liquor locked up and out of reach.
• Don’t smoke or use tobacco products in the presence of children. If you do use, don’t leave these products out; return them to childproof storage when finished.
• Keep all motor oil, paint thinners, lighter fluid and gasoline stored away from reach.
• Be sure to check battery-operated toys to ensure that batteries are secure (especially button batteries), and be mindful to store all batteries out of reach.
• Don’t leave personal care products, makeup/cosmetics or hair and nail products out after using them. Return them to out-of-reach storage as soon as you’re done with them.

Parenting is hard enough without the daunting burden of worrying about “what would happen.” Almost all poisonings of young children are accidental, so take precautions to prevent poisonings before they occur, and know what to do, just in case.

Factually reviewed by Dr. Seran Kim, board-certified Emergency Physician, on June 21, 2021.

Sources:

• Centers for Disease Control and Prevention: Poisoning