Iron Poisoning in Young Children
Hunter, Beatrice Trum, Consumers' Research Magazine
Iron-containing supplements are the leading cause of accidental poisoning in young children. They now surpass aspirin, formerly the most common cause of childhood deaths from ingestion, according to the National Capital Poison Control Center at Georgetown University in Washington, D.C.
From 1988 through 1992, about 17% of all children's deaths reported to poison control centers in the United States were due to iron poisoning. This represented an increase of 5% from the preceding period of 1984 to 1987. Since 1986, the number of young children who accidentally swallowed iron-containing supplements more than doubled and involved more than 110,000 children under six years of age.
Commonly, the strong bitter taste of iron is masked by a sweet coating on supplements. The products may look like candy. As a result, they attract young children.
The Food and Drug Administration (FDA) noted that initial symptoms of iron poisonings are found at a level of 250 milligrams (mg) total iron for a 10-kilogram (kg) child (22 pounds). But ingestion of 60 mg/kg total iron for a 10-kg child is considered the minimum intake for the development of significant iron poisoning.
Young children who swallow iron-containing supplements are at serious risk of gastrointestinal blockage, metabolic acidosis, shock, coma, or cardiovascular collapse. In a small child, as few as five or six pills may be fatal. In cases of iron poisoning, speed of diagnosis and application of therapy are important. Chelation therapy is an effective treatment if it is given within four hours after iron ingestion. The FDA reports that, with early treatment, the mortality rate from childhood iron poisoning was reduced from 45% to about 1%.
In many poisoning cases, toddlers have ingested their mothers' prenatal iron tablets. In most instances, the products had high dosages (60 to 90 mg of iron per tablet). Rarely have physicians informed pregnant women of the potential dangers of the supplements to toddlers. Now, physicians are being asked to consider carefully before recommending high-dose tablets of iron supplements to pregnant or lactating women.
Frequently, toddlers' access to iron supplements results from adult carelessness or ignorance. In some reported cases, tablets left within reach of young children were in uncapped or loosely capped containers. Or, adults transferred supplements from the original containers to those that were not child-resistant. Older children, able to open child-resistant packages, have fed supplements to young siblings. In one report, a mother gave a bottle of iron supplements to her six-month old infant to use as a rattle.
As early as 1978, the Consumer Product Safety Commission (CPSC), the agency responsible for regulating packaging of household substances, was concerned with the problem of accidental iron ingestion by young children. …