Why Did My Kid React to That Food?

Little chief-cook tasting the carrotKids can have reactions to food for many different reasons. They can be allergic, sensitive, intolerant, or have problems because the food contains poisons or has drug effects.

Food allergies are caused by a child’s immune system reacting to a food, similar to the way they can react to pollen or bug bites. Allergic reactions are usually to the protein in the food rather than the sugar or fat, and are usually immediate. The most common severe reactions are to tree nuts, peanuts, and shellfish. Less severe reactions are most common with cow’s milk, eggs, soy, wheat, and fish.

Celiac disease is in this category. People with celiac are allergic to the gluten protein in wheat and react with their immune system if they are exposed to even a tiny amount. Gluten allergy was worth a whole blog all by itself: A Gluten Free Blog.

80-90% of the time, kids will outgrow allergies to eggs, wheat, milk, and soy by 5 years of age. They outgrow peanut allergies only 20% of the time. (Do NOT experiment with this!) Fewer will outgrow allergies to tree nuts and seafood.

Symptoms of an allergic reaction include:

  • Skin rashes. Hives, or whelps–itchy raised patches with pale centers and red rims. Hives move around, fading in one area to reappear in another. Antihistamines like Benadryl (diphenhydramine) help the symptoms.
  • Breathing problems. Food reactions can make kids wheeze, make their throats feel tight, and give them sneezing fits.
  • Gastrointestinal symptoms like nausea, vomiting, and  diarrhea.
  • Circulatory symptoms like paleness, lightheadedness, and loss of consciousness.
  • Severe reactions can involve several of these areas, and are called anaphylaxis.

Food sensitivities and intolerances are not allergies. Some children can be sensitive to the common effects of a food and react strongly. For example:

  • Apples, pears and bananas contain pectin and can be constipating (useful if your child has diarrhea). Some children can get stopped up if they eat too many.
  • Dairy products can also constipate–some kids will never poop again if they eat a lot of cheese. (This may be a slight exaggeration.)
  • Sugar can cause diarrhea, so children may have problems if they drink a lot of juice. (Interestingly, we have never been able to prove that sugar makes kids hyper.)
  • Kids can react to dyes and preservatives in foods–they will feel nauseated or tired, and we have proven that red dye can make them hyper.
  • Lactose intolerance is an reaction to the sugar in milk. People who are lactose intolerant are missing the enzyme (lactase) that breaks down the sugar in milk (lactose). They get bloating, gas, and diarrhea.

There are certainly plants that contain toxins (poisons) in themselves–poisonous mushrooms, apple seeds, and belladonna are examples–but most poisonings are accidental, usually from foods that have spoiled:

  • C. Botulinium bacteria grows in improperly canned food and in cans that have rusted through.When we used to give Karo syrup for constipation, the bacteria would grow in Karo left on a cupboard shelf and children would die, paralyzed by the neurotoxin (nerve poison) that the bacteria produced.
  • Staph Aureus can grow in spoiled food and produce a toxin that is usually self limited in its effect, giving kids cramping, diarrhea, and vomiting.
  • Clostridium perfringens produces a similar toxin, and is frequently the villain in cafeteria incidents and contaminations in soil and sewage.
  • Salmonella can grow in spoiled meat, eggs, and milk and give your child diarrhea, vomiting and fever.
  • E. coli is more likely to grow in beef, but can be found in mishandled produce. Same unpleasant symptoms.
  • Shigella is common in daycare outbreaks. It causes the same nausea, vomiting, diarrhea, and fever, but has the added risk of seizures from the toxin it produces.

Foods can also have drug effects. The best examples of this are drinks (coffee, tea, energy drinks) and food (chocolate) that contain caffeine. Caffeine makes kids restless, shaky, and interferes with their sleep. In large doses, as with energy drinks, it can produce a rapid heartbeat, muscle tremors and seizures. There were 20,783 emergency room visits from energy drinks in 2011; 5 people died after consuming them. The youngest was a 14 year old girl.

Foods can also be irritants. For example, babies can get rashes around their mouths or diaper rashes from acidic foods.

People do not react to a food solely because it is a GMO (genetically modified organism)–GMOs are not something you need to avoid unless you have a reaction to the particular item. GMO wheat produces the same allergens as non-GMO wheat; if you are allergic to one, you will be allergic to the other. Also the subject of an entire blog: What’s the Deal with GMOs?

In conclusion, not every food reaction is a food allergy. Avoidance or treatment of the food reaction varies with the actual cause. If a child has an anaphylactic allergic reaction to peanuts, he or she never needs to be around peanuts again. They may outgrow other allergies. If they get gassy from a lactose intolerance, they can take lactase tablets when they eat dairy. Kids who become constipated with apples or cheese need to limit the number they eat. It is always important for every child to not be fed spoiled food or energy drinks.

Knowing in what way your child reacted to a food determines what you do about it in the future. Knowledge rules.

Domesticated Momster
Rhyming with Wine
Rhyming with Wine

8 Easy Ways to Prevent Childhood Cancer

Cute girl of school age in superhero costume

More than 9000 kids get cancer in the US every year (about 1 in 450). The most common are leukemias, lymphomas, and brain tumors, but there are many different kinds. If you would like up to date numbers, the  AAP has them here.

Cancer is a group of more than 100 diseases caused by the cells in a person’s body multiplying out of control. Cancer is separated into different types depending on what sort of cell it originated from (blood, brain, lung…) and if it invaded nearby body parts (a tumor) or spread to other organs (metastasis). That might be a smidge simplified, but you get the idea.

Your children’s genes, the DNA they inherit from you, influence their risk of cancer–not something you can change. But lifestyle and environment also influence their risk, and there you can have an impact.

That impact includes not only your kid’s exposures in childhood, but also the example they see in your behavior and the habits you establish that will carry forward into their adult lives. What you teach them in childhood can protect them throughout their lives.

What to do to lower your child’s risk of getting cancer:

  1. First, the obvious one: don’t use tobacco, and don’t allow anyone else to smoke around your kids. I know, easier said than done, but an estimated four out of five cancers are caused by tobacco. The poisons in tobacco damage DNA, increasing the incidence of 14 different cancers including lung, some leukemias, voice box, throat, liver, kidney… Secondhand smoke alone increases cancer risk by 25%. The sidestream smoke off the burning end of a cigarette has 3 times the carbon monoxide, 10 times the nitrosamines and hundreds of times the ammonia of exhaled smoke. Add to this that if you smoke, your child’s chances of becoming a daily addicted smoker increase by 25 times, boosting their risk even more. Just don’t. No excuse is good enough.
  2. Also well known: protect them from sunburns to prevent skin cancer. Use at least SPF15 and reapply through the day. Seek shade during peak hours. Stick a hat on their head that shades their face, and a pair of sunglasses on their nose.
  3. Feed them a healthy diet with lots of fiber, fruits and vegetables. Avoid processed meats and an overabundance of red meat and salt. A healthy diet helps your body remove harmful chemicals, prevent and repair damage to DNA, and block the formation of cancer causing chemicals. A less healthy diet has been linked to breast, mouth, esophagus and GI cancers.
  4. Encourage exercise. Exercise stabilizes levels of hormones like estrogen and insulin that have been linked to cancer. An active lifestyle decreases the incidence of breast, bowel, and uterine cancers.
  5. Keep them at a healthy body weight. Fatty tissue produces hormones that influence the way cells grow. Cell overgrowth is at the root of cancers. Obesity has been linked to breast cancer, esophageal and bowel cancers, and liver, kidney, pancreas and uterine cancers.
  6. Limit their exposure to chemicals. Indoor pesticides have recently been shown to  increase children’s risk of leukemia by 47%. Be aware of the chemicals you might be exposed to at your job, wear appropriate safety gear, and don’t bring poisons home on your clothes–cancer causing chemicals such as arsenic, benzene, and asbestos are still used in industry. Check the use instructions (do they need to be used in a well ventilated area?) and ingredients in the products you do use at home. You can check for harmful ingredients in household products at nih.gov. Store household chemicals such as cleaners, paints, degreasers, and strippers safely high up and locked away.
  7. In the “be a good example” category: limit your alcohol consumption. Alcohol increases the amount of cancer causing chemicals in your body, and affects hormone levels. It also amplifies the toxic effects of tobacco. Drinking alcohol increases your risk of breast, mouth, throat and bowel cancers.
  8. Avoid certain kinds of infections. Infection can increase cancer risk by causing chronic inflammation and suppressing the immune system. Hep B increases your kid’s risk, so get them the vaccine, and teach them to avoid iv drugs and indiscriminate sex. Be careful with tattoos: Hep C also increases risk, and 41% of it comes from tattoos. Helicobactor pylori  increases cancer risk–doctors look for it with reflux disease, gastritis and ulcers.  Human Papillomavirus  works by causing cells to divide rapidly (hence the appearance of a wart). We lose 4000 women to preventable cervical cancer yearly, and the incidence of oral cancers due to HPV is increasing dramatically. The CDC recently announced that the vaccine has decreased the incidence of HPV in teens by 2/3. Get your child the HPV vaccine when he or she hits 11 or 12.

Cancer risk factors seem to hit the hardest when a baby is still in the womb, and in adolescence when their bodies are rapidly growing and changing, so these are the times when a parent can absolutely have an effect in preventing cancer.

A healthy lifestyle stacks the deck in your child’s favor, dramatically decreasing their odds of getting cancer. Protect them from cancer causing sunburns and poisons, get those vaccines, establish good habits, and be a good example. There is no down side to a healthy diet, regular exercise, and limiting their exposure to toxins, and it may increase their chances of hanging around for a while.

Domesticated Momster

Lead, and the Children of Flint

Toddler-Playing-With-A-Chair-01In April of 2014 politicians in Flint, Michigan changed the city’s water supply from Lake Huron and the Detroit River to the Flint River, in order to save money. The water from the Flint River was more acidic and had more salt and chlorine in it, and it corroded the aging lead pipes through which it flowed, allowing lead into the water and poisoning the inhabitants of Flint.

The EPA allows 15 ppm (parts per million) of lead in drinking water. Water from homes in Flint tested as high as 13.2 thousand ppm. Lead levels in children’s blood doubled, then doubled again.

Nontombi Naomi Tutu said we “needed the people of Flint to remind the people of this country what happens when political expediency, when financial concerns, overshadow justice and humanity.”

Why do we worry about Lead?

Lead is a soft gray heavy metal that functions in our bodies as a neurotoxin–it poisons nerves. Acute lead poisoning causes headaches, stomach pain, clumsiness, agitation or drowsiness, convulsions and death.

Chronic lead poisoning is more insidious. Lead is most harmful to infants, children and pregnant woman, because it damages developing nerves. Kids who are poorly nourished will be more affected because deficiencies in iron, calcium and zinc increase their body’s absorption of lead. Babies are more at risk because they live closer to floors and surfaces and everything goes into their mouths. Exposed children:

  • can lose cognitive function and develop speech and reading problems.
  • can be unable to focus and organize their thoughts, and exhibit behavior problems.
  • have a higher school dropout rate, problems with aggression, and a higher rate of delinquency.
  • can have damage to their hearing.
  • will have problems growing because lead messes with their ability to use Vitamin D and iron.
  • become anemic, which leaves them less able to transport oxygen around their bodies.
  • can cause damage to their kidneys, giving them lifelong problems with hypertension and cardiovascular disease.

Where is lead found?

When I was a kid we wrote with lead pencils and had lead in our gasoline!

Nowadays, lead is used in some industries, found in deteriorating lead paint in old houses, and leached out of old lead water pipes and pipes with lead solder. We also occasionally run into it in old toys, old Christmas decorations, and jewelry, and in toys, ceramics and cans imported from other countries. Cosmetics such as surma and kohl can have lead, as can some home remedies and dietary supplements. A few years ago there were crayons with lead in them. The manufacturer said, “Kids weren’t supposed to eat them!”

Ideally, we prevent lead poisoning.

  • If you work in an industry that uses lead, take off your shoes when you enter your home.
  • Don’t give your kids old toys and jewelry to chew on.
  • If you have lead pipes in your home, run the water for 30 seconds before you use any of it to drink or cook, because lead will gradually leach from the pipes it is sitting in. Never drink or cook with water run hot from the tap–hot water leaches out more lead.
  • If you live in an old house, clean up peeling paint and household dust with a wet mop.
  • Check for lead paint before any home renovations.
  • If you have well water, test it for lead. Most well filters do remove lead.
  • Give your child a nutritious diet to avoid deficiencies in iron, calcium, and zinc.

Treatment for Lead Poisoning:

Pediatricians generally check children’s lead levels at 12 months and sometimes 2 years, and any time there is concern.

Treatment of lead poisoning varies with how high the level is.

Between 5 and 45 mcg/dl, treatment involves finding and eliminating the source and optimizing the child’s nutrition. Levels as low as 5 mcg/dl have been shown to have lasting effects on children, but chelation therapy at these levels has not been proven to have any effect on kids’ cognitive ability or behavior.

Kids with levels over 45 mcg/dl need to be treated with chelating agents, which can be quite dangerous. Chelators bind the metal in the blood and improve its excretion into urine and stool. Unfortunately chelators also bind minerals that your child’s body needs for normal growth and development. Also, kids can be allergic to the chelators, and the medicine can damage their liver or kidneys.

Far better to prevent the exposure.

I do not have words for how horribly the people of Flint were betrayed by their elected officials.

Some resources if you have concerns:

  • EPA Safe Drinking Water Hotline  800-426-4791
  • Poison Control 800-222-1222
  • Pediatric Environmental Health Specialty Unit Network (PEHSU) 888-347-2632

 

Domesticated Momster

Top Ten Holiday Poisonings

Cute kid girl in glasses thinking about gift on Christmas holiday. Vintage portrait

or, “how to avoid visiting the Doc during the Holidays”:

  1. Tiny magnets: These aren’t really poisonous but they can get stuck in noses and ears, choked on or swallowed. Keep track of the big kid’s toys so I don’t have to make the little one cry digging something out of his or her ear. Worse, magnets that are choked on or swallowed can require surgery to remove. Two magnets in the gut will stick to each other and wear through the bowel wall.
  2. Button batteries: Same problems as above, plus they can leak and cause burns, eating holes through the bowel that can be fatal.
  3. Grandma’s meds: These are on countertop at her home, and sitting in her unattended purse when she is visiting yours. This is the most common poisoning that I see. Other people’s meds also count, of course.
  4. Household poisons: Both the usual suspects (cleaning products, bug sprays) and the holiday specific (liquid fuels) are more available and less monitored in the holiday craziness. Lock ’em up.
  5. Food: Avoid potato salad that was made on the counter where they just cleaned the chicken. Return leftover food to the refrigrerator quickly. Wash those hands! Pick up and throw out unfinished drinks–kids can drop their blood sugar and fall into a coma with a relatively small amount of alcohol. Throw away cigarette butts, because kids eat them and the poisons in cigarettes can actually throw small people into a seizure. (And we inhale these things on purpose. Blech.) Add e-cigarette refills to this list for the last couple of years. 1/2 tsp can kill a child.
  6. Decorations: It’s actually pretty hard to poison anybody with holiday décor. Antique items will sometimes have lead, so don’t let the little guy eat the metalics. Don’t breath in the spray snow, because it has either acetone or methylene chloride in it. And don’t hit Uncle Joe with that branch, no matter how tempting….
  7. Plants: Poinsettias are not poisonous. Promise. Neither is Christmas cactus. Holly berries, mistletoe berries and peace lily berries are, as are bittersweet and boxwood.
  8. Smoke and carbon monoxide: Very poisonous. Live trees and decorations can be dry and fires, candles and space heaters abound. Keep your eyes open and your smoke and carbon monoxide detector batteries fresh.
  9. Mind numbing toys: Boycott toys that don’t engage your children’s minds. Look for toys that they can create with, explore with, or build with. I know this is not strictly a poison, but it’s my list, so I can bend the rules. So,…
  10. Poisonous soul numbing holiday insanity: Back up and take a breath before you spend money you don’t have on stuff you don’t need. Defeat stress and exhaustion with a healthy diet, exercise and regular sleep. Celebrate your heritage, enjoy your family and friends and create joyful memories. Ditch the rest.

Pesticides: Not a Major Food Group

bleach boy-01A recent statement from the American Academy of Pediatrics suggested that we should limit our children’s exposure to pesticides.

It turns out that chemicals designed to kill insects and rodents are not good for children. Who knew?

In large doses, pesticides cause acute poisonings, with symptoms including dizziness, nausea, headaches, twitching or weakness. Smaller doses over a longer time can harm your child’s brain or hormonal systems. When pesticides injure a child’s brain they can cause developmental delays, and attention and behavior problems. Hormonal effects can impact your child’s growth and perhaps his or her reproductive ability. We do need to limit our children’s exposure!

Children are more vulnerable to poisons than adults, not less. Their bodies are actively growing and maturing and are thus easier to damage, like a gymnast caught mid leap. They have faster metabolisms: their hearts beat more quickly and their lungs breathe more rapidly, allowing chemicals in more quickly and in larger amounts. Also, their protective systems aren’t mature and don’t work as well as those of adults to stop the damage.

So, how do we lower children’s exposure in our day-to-day lives? The most common place for your child to ingest pesticides is in the food that they eat, particularly the fruits and vegetables. This does not mean they can skip their veggies! Just wash them first, eat a variety of different produce (different vegies have different amounts of pesticides), and buy organic when you can. Your local farm stand is, of course, your best friend.

Children are also exposed to pesticides in their homes and yards, so we may need to make some changes there. Keep all of your household pest products in their original containers with child proof caps intact. Just today I had a child drink a degreaser because her mom had stored it in a soda bottle! Store poisons out of reach and out of sight in a locked cupboard. If you are using a pesticide and the phone rings, close the container and put it out of reach while you are out of visual range. I have seen more than a few kids poisoned when mom went to see why the baby was crying, or to answer the door. Kids are quick.

Read and follow the directions on the container. Use pesticides only when there is a problem, never to just prevent one. Less is always better. When you do use them, use crevice and crack treatments, not bombs. Think about how your kids live on the surfaces to which you are applying the treatment: kids lie on the ground, crawl under things, and touch stuff and put their hands in their mouths. Don’t put the rat poison behind the couch – your 2 year old will find it. My amazing, brilliant grandchild found the mouse poison behind the dishwasher. World’s worst grandma.

Change your clothes after you use pesticides, and store your shoes outside.

If you have a wooden play structure that was built between 1970 and 2004 and not made of cedar or redwood, the wood was probably treated with chromated copper arsenate. Arsenic also is not good for children, so you may want to replace the structure.

Read the ingredients on lawn and garden products and any pet products. Organophosphates (most commonly malathion, but there are dozens) were banned from home use in 2001, but many people have old products sitting around, or use commercial products at home. They are also still used in public parks and schools.

In America we use more than 1 billion pounds of pesticides every year in our farms, homes and public spaces. Ask what is used by your city and at your child’s school. There are many newer, safer products that have been developed in the last few years, so suggest alternatives and avoid the organophosphates when you can.

Stay safe and be healthy!

4th of July: Avoid the Doctor!

safety signSunshine, water, and fireworks. What else could you need? To avoid the ER afterwards!

Oddly, most 4th of July injuries actually have nothing to do with fireworks, and everything to do with parents being so busy that they are not as watchful as usual. Sports are more dangerous when we want to impress cousins. Teenagers tend to get more reckless during a celebration, and young children sneak away quickly.

Most injuries are from everyday activities and household objects made dangerous by the craziness. So,…

Top Ten things that will land you in my office after the fireworks:

1.  Drowning: The 4th is all about water. Every year pediatricians see drownings and near drownings on the 4th. Never leave any child alone for even a moment near open water, whether it is an ocean, a bathtub, or a water bucket.

All it takes is one moment of inattention for a child to slip away. If there is open water, you need to be within touching distance and focused on your child. Pools should be fenced in and closed off with a self-latching gate at the end of the day, and all the toys should be put away. Life vests are fabulous for a parent’s mental health and relaxation (swimmies and floaties are not life jackets). Life preservers and a shepherd’s crook should be placed obviously nearby wherever kids are swimming. For more tips on water safety, check out my summer safety tips.

2.  Fireworks: I know, it’s obvious, but it had to be on the list. Please leave them to the professionals. It’s not worth months in the burn unit and doing physical therapy.  No-one thinks it will happen to their kid, until it does.

3.  Choking: Toddlers will put anything in their mouths. This means that everybody needs to pick up his or her stuff. Items over 1¼ inch in diameter are generally safe. Items smaller than 1¼ inch can go straight into their gut or lung. The most dangerous items to swallow are button batteries and magnets; the most dangerous to choke on are grape sized (older children’s toys, hard candy) or stretchy (balloons, plastic bags, marshmallows). Clean up!

4.  Allergic reactions: Holidays provide a banquet of things to irritate children’s allergies. Plants, foods, cigarette smoke, bonfires and other people’s homes and pets come to mind. Avoid them if your child has allergies.

5.  Fires and electrical injuries are especially common during holidays. Decorations can be flammable, candles and fires are commonly nearby. Frayed and loose wires easily start fires. I have had an astounding number of children run through banked campfires after dark. Block them off please!  Keep your eyes open for dangers.

6.  Poisonings: The one I see most is an overdose on Grandma’s meds. At Grandma’s home they are left on countertops; at your home they are in her purse. A left over drink is also a common way to poison children. A little alcohol can drop a child’s blood sugar and throw him or her into a coma.

7.  Alcohol inside the grown-up: does this really need explanation?

8.  Dehydration/Food poisoning: Watch their intake. It’s hot and the kids are running around in endless circles. Bring lots of water (the stuff mother nature made for you, not the stuff with caffeine and sugar added). Food left out in the heat for hours can grow things that cause vomiting and diarrhea. If you don’t know where it came from and how long it’s been there, don’t eat it.

9.  Scarce common sense: If it doesn’t seem safe, don’t let people pressure you into it. Make them wear that bike helmet! Trampolines and motorized vehicles (Sea Doos, dirt bikes) are never a good idea.  Feel free to let watching your kids take precedence over seeing Uncle Joe’s trophy or Aunt Mary’s vacation photos. “He’ll be fine” doesn’t make him fine. Keep an eye on him.

10.  Politeness: Feel free to be rude and head for home when the kids get tired, if a situation feels out of control, or if your child is being exposed to something you aren’t happy with. Use the munchkin’s youth or fatigue as the excuse for you to head home, relax and read a bedtime story.

The point of celebrations is to solidify relationships and give hope for the future. Focus on family, rejoice in the day and be careful.  Keep plans simple, pick fewer things to do, and do them together. Be safe and stay healthy.

Trendy Poisons for your Kids

tidepod-01Kids always seem to find new and interesting ways to hurt themselves, intentionally or accidentally. Poisoning is the #1 or #2 cause of injury death annually, fighting for that honor with car accidents. The annual numbers on poisonings are out (thank you, Annals of Emergency Medicine). The new winners are opioids, laundry detergent packets, bath salts, synthetic cannabinoids, and energy drinks.

Opioids are the traditional first place winner for deadly poisonings, and they are in that spot again this year. 90% of poisoning deaths involve drugs, and opioids are involved almost half the time. Opioids include all of the narcotic painkillers. They are intentionally abused because of the euphoria they induce; they are also accidentally ingested because people keep them laying around the house on countertops and in purses. When taken in high enough doses, the kids who took them forget to breathe; when taken chronically they are addictive.

The new second place finisher is laundry detergent packets. They are a problem because they are more concentrated than traditional laundry detergent, and can cause nausea, vomiting and sedation when taken by mouth, and irritation when put in contact with skin and eyes.

Bath salts” have been popular since 2010. They are substituted cathinones (stimulants) which cause disorientation, extreme paranoia, and violent behavior. In 2012 there were 994 reported exposures and 16 deaths. They are called bath salts because they resemble Epsom salts, but are also known as plant food, ivory wave, vanilla sky, and bliss.

Synthetic cannabinoids (man made marijuanas) are common now and have an added level of danger above Mother Nature’s version. Kids have anxiety attacks, psychosis (loss of contact with reality), rapid heart rates, and seizures. In 2012 there were 5225 reported exposures and 6 deaths. The kids call this stuff spice, genie, Yucatán fire, or aroma. Drug screens do not pick it up.

Energy drinks are on the upswing, causing about half of the 2.3 million calls to poison control centers in 2012. They cause seizures and heart rhythm abnormalities.

The new kids on the block are the liquid nicotine refills for  e-cigarettes, which come in vials without child resistant closures. One teaspoon is enough to kill a child. Liquid nicotine is unregulated, which means that in 10 states and DC a child can buy it; it can be advertised to children in all but 4 states. In 2014 poison control received 3353 calls for exposure to nicotine products, up from 1543 the prior year. Children can be exposed by inhaling the vapor, by swallowing the liquid, or by absorbing it through their skin. Children experience a racing heartbeat, vomiting, and grunting breaths, before they loose control of the muscles in their upper body and die.

So take a few minutes to clean out your medicine cabinet. Throw out meds you don’t take anymore. Lock up the ones you do take, vapor refills, and laundry detergent packets. Don’t buy energy drinks. Talk to your kids about the risks of  drug use, and learn the language they are using. While you’re at it, lock up the rest of your cleaning products and pesticides as well.

Poison control’s phone number is 1-800-222-1222 in the US; keep it posted on or in every phone. They are excellent in an emergency, and they have more in depth analysis of which age groups are taking what and why on their site, if you are interested.

Be safe. Safe is always better than sorry.

How to Prevent Carbon Monoxide Poisoning

Okay, I tried, but there is just no way to make carbon monoxide interesting. Read it anyway, because it’s good for you: you need to know this stuff. Like eating your vegetables. Every one of us encounters carbon monoxide on an almost daily basis, because it is ubiquitous and sneaky. We need to know where it comes from, how to avoid it, the symptoms it causes, and what to do if we or our children are exposed.

Carbon monoxide (CO: one carbon, one oxygen) is a colorless, odorless, tasteless, and initially nonirritating gas produced largely by partial oxygenation of carbon based fuels. Complete oxygenation would produce carbon dioxide (CO2), which we exhale every time we breathe. Plants use that to make us more oxygen.

CO can accumulate in poorly ventilated, enclosed areas. When we breathe in large amounts, the CO binds with the hemoglobin in our blood and forms carboxyhemoglobin. Carboxyhemoglobin circulates through our bloodstreams like the regular stuff, but it does not like to release its oxygen to our brains, hearts, muscles, and organs. We suffocate while still breathing the air around us.

Aristotle, who lived around 300 BC, was the first person to note that coal fumes led to “a heavy head and death.” In ancient times, it was one way criminals were killed: they were locked in a small room with smoldering coals.

It is thought that CO is to blame for some haunted houses: its accumulation can cause hallucinations, disorientation, and delirium.

Oddly, a little CO can be a good thing: it is an anti-inflammatory, encourages growth of nerves and blood vessels, communicates between nerves, and may have some function in long term memory. Very little. Don’t go looking for it.

Statistics on CO poisoning vary significantly with who’s reporting them. It is considered to be the leading cause of poisoning injury and death worldwide. Poison help lines in the US report about 15,000 calls a year, with an estimated 70 deaths. Approximately 40,000 people seek medical care for exposures, and CO accounts for around 15,000 ER visits each year. The CDC estimates more than 500 deaths per year overall in the US, with the largest percentage being in the under 5 age group. More poisonings occur in the winter (gas heaters) and after disasters (generators).

CO is created by burning carbon-based fuels (wood, gasoline, diesel, propane, kerosene, lamp oil), by smoking (tobacco is a carbon based fuel), and by exposure to methylene chloride (degreasers, solvents, paint removers). Don’t smoke (so many reasons), and use degreasers, solvents and paint removers only in well-ventilated areas. Appliances that can produce CO need to be maintained, inspected annually, and well ventilated. Some of the most common ones are:

  • Forced air furnaces
  • Wood stoves/fireplaces (open that flume!)
  • Space heaters (non-electric)
  • Gas water heaters
  • Gas stoves
  • Gas dryers
  • Anything with a pilot light
  • Barbecues, Hibachis
  • Automobiles (never run them in an enclosed space!)
  • Generators
  • Fuel powered tools (if you put gas in it, don’t use it indoors)
  • Boats (don’t use those indoors either)

Symptoms of acute (not chronic) CO poisoning include effects on the brain (dizziness, headache, confusion, lethargy, drowsiness, irritability, irrational behavior), lungs (shortness of breath) and heart (palpitations, paleness). If exposure continues, loss of consciousness and death will follow.

Chronic exposure to lower levels of CO can result in headaches, depression, confusion, memory loss, nausea, and permanent neurologic damage.

Pregnant women, fetuses, and children are especially sensitive. As with most poisonings, children’s small bodies are more sensitive, their higher metabolic rate brings it into their bodies more quickly, and they don’t have the ability to escape.

People with lung, blood, or heart disease, like asthma or anemia, are also more susceptible.

Of note is that CO damage from methylene chloride can last twice as long as that from burning carbon based fuels, because it is stored in our tissues.

Overall, it is a good idea to prevent any exposure to CO. Maintain and inspect those appliances, and make sure they are vented. Open the flume when you have a fire in the winter. Never barbecue or use a hibachi indoors. Throw out the cigarettes, because people who smoke have levels of CO in their blood streams several times higher than non-smokers. Perhaps most important, since you can’t smell this stuff, install CO detectors near every area where people sleep. Many newer fire alarms contain CO detectors, making this even more convenient.

If you are exposed, go outside into clean air. If you are having any symptoms (light-headedness, shortness of breath, seeing ghosts…) seek medical attention. They will give you oxygen and monitor your heart and brain.

Yay! You made it through, even the dreaded chemistry. Not as bad as you thought, right? Knowledge rules!

How to Prevent Poisonings in Children

Prevention of poisonings is the grunt work of parenting. It is completely boring, repetitive, and endless. It is also absolutely necessary. I will try to make it as painless as possible.

First, some statistics to motivate you. In 2013, there were more than 1 million calls to poison help lines for children under 6 years of age. That’s almost 3000 kids a day exposed to potential poisons. 29 children died. Not that big a number unless, of course, yours is one of the 29.

Let’s keep that from happening.

The phone number for poison control is 1-800-222-1222. Stick it on every phone in your home, input it into your cell phone, and also into the grandparents and babysitter’s cell phones. Hopefully you will never need it.

The number one thing that will keep your children from being poisoned is your attention. They can’t get those pills off the counter or that detergent from under the sink if you are watching them.

Unfortunately, it is impossible to watch every child every minute of the day, so do safety proof your house and your habits so bad things won’t happen during a moment of inattention.

  • Store poisons up high (kids can’t reach them), out of sight (they don’t see them and become curious), and locked up (when all else fails, they can’t open them).
  • Make the locks automatic so you don’t have to remember to lock them as the phone is ringing.
  • Keep poisons in their original, labeled containers.
  • Don’t ever put poisons in anything that looks like a food container. I once had a child drink gasoline out of a big soda cup.
  • Don’t keep poisons in a purse, because kids love to explore purses. And because no-one keeps purses locked up and out of sight.
  • Keep the original child safety caps on everything, even though they are a pain.
  • Throw away poisons that you no longer need or use.
  • Don’t take medicines in front of a child, because children are excellent mimics; never call medicine candy, because they like candy.

So, what is a poison? Lets keep the definition loose: anything a child can ingest, absorb through their skin, or inhale that will do him or her harm. Another list!

  • Button cell batteries: They can eat right through the gut. They are in remote controls, key fobs, musical cards and books… Keep them out of reach.
  • Medicines, including vitamins, minerals, iron pills, and herbals: these are all more dangerous in a child’s tiny body.
  • Cleaning supplies: drain cleaner is a nightmare, bleach burns, abrasives abrade, furniture polish oozes into their lungs… Lock ’em up! Lock up those little laundry detergent packets too.
  • Pesticides: yuck. They cause fever, tiny  pupils, vomiting, breathing problems, twitches, seizures, and death. Respect pesticides.
  • Car stuff: gasoline, antifreeze, wiper fluid… Make yourself a high spot in the garage, too.
  • Heating stuff: coal, wood, and kerosine heaters need to be kept clean and in good working order; Kerosine and lamp oil are on the lock up list. Install smoke detectors and carbon monoxide detectors since you can’t lock up smoke.
  • Alcohol: you wanted to lock that up anyway, didn’t you? Kids drop their blood sugar when they drink alcohol, and can go into a coma.
  • Tobacco: The big worry is the liquid nicotine for vapor refills. 1/2 tsp can be toxic, they are not regulated, and they do not have child resistant caps.
  • Small magnets: not fun when two of them get together on opposite pieces of gut.

Now, about those habits. We tend to get stuff out of those locked spaces to leave on the counter, in a purse, or sitting open where we are working. Regret is not a fun emotion. Neither is guilt. Don’t leave those pills on the counter and go get a drink to swallow them with; pour out the drink glasses immediately after the party, put away the cleaning stuff before answering that phone. Be aware of any poison you have out, until it is locked up again.

The one thing that messes up all this preparation and care is a holiday, with all its incumbent disruption. Be especially vigilant during a holiday, a special occasion, or when you have guests. Stuff is everywhere, everything is hectic, and no-one is watching the kids.

Suspect a poisoning when your child vomits, has a strange odor, has staining on their clothes or around their mouths, burns around their mouths, or when there are open containers around.

If they look OK, call the poison help line, and be prepared to tell them what you think the child took, how much, how big he or she is, and where you are. Have the bottle in your hand when you call.

If something splashed into their eye, rinse it with tepid water for 15 minutes. Hold the eye open and aim the water at the corner by the nose.

If the poison is on their skin, take off the clothes covered with the poison, and rinse the child in the shower for 15 minutes.

If the child inhaled the poison, take them outside into fresh air.

If your child is unconscious, having trouble breathing, or seizing, call 911.

Take a CPR course, because everyone should.

Prevention of poisonings may not be the most fun and inspirational thing you do as a parent, but if you set the house up right and then watch your habits, you will never have reason for regret.