Christine Bradley
Accidental iron poisoning is the leading cause of poisoning deaths among young children. Since 1986, poison control centers across the nation have received reports of more than 110,000 children under the age of six accidentally ingesting iron tablets. According to the American Academy of Pediatrics, "Iron medicines are one of the most serious causes of poisonings in children younger than five years."
Although FDA regulations put into effect in 1997 requiring all iron-containing drugs to contain a warning about the risks of iron poisoning in children, the public is still largely unaware of the danger. Since the mid-1980's, incidents of accidental iron poisoning have nearly doubled.
Why Is Iron Poisoning On The Rise?
Since the mid-1980's, when there was an increased awareness of iron-deficiency anemia, especially in children and pregnant women, more families began keeping iron-supplements in their homes. Though iron-deficiency anemia is a common concern for women and children, increasing one's intake of iron-rich foods such as lean red meats, leafy green and yellow vegetables, and some seafood can treat most cases.
However, iron supplements are prescribed by physicians in some cases, especially for pregnant women whose RDAs (Recommended Daily Allowances) for iron are as high as 18mg per day. Iron supplements are also available over the counter and, as a result, many families keep iron supplements handy. Iron supplements are available as tablets, drops, syrups, and capsules. Many families with young children, unaware of the dangers of iron overdose, do not store these supplements out of reach of their children.
How Much Iron Is Too Much?
The amount of iron considered to be an overdose varies from child to child. As a general rule, symptoms of iron overdose will appear when doses greater than 10mg/kg (of the child's weight) are taken. For example, for a child weighing 18kg, or approximately 40lbs, ingesting 180mg of iron would cause symptoms of iron poisoning to appear. The RDA for iron in children ranges from about 7-10mg per day. If you are concerned that your child may be anemic, a hematocrit or hemoglobin blood test can help determine if a supplement is necessary.
What Are The Symptoms?
Unfortunately, children are often reluctant to admit that they have taken medicines, so parents must rely on sources other than their child to determine if they have taken iron, and if so how much. One of the most reliable indicators is an open bottle of iron supplements. Counting the number of pills or amount of liquid remaining in the container is a good indicator.
Physical symptoms to look for in your child are severe nausea, vomiting, gastrointestinal bleeding (most often vomiting blood), and diarrhea. These symptoms may appear as quickly as 20 minutes after the overdose has occurred. Even if the symptoms go away but you suspect your child took an iron pills or liquid, it is still critical that you call your local poison control center or take your child to a health care facility for evaluation.
Left untreated, a child may go into shock with a severe blood chemistry imbalance, have a seizure or go into a coma. Prolonged iron toxicity may cause damage to the stomach, liver, kidneys, blood vessels, and brain. A fatal outcome is closely related to the early onset of coma or shock, so it is crucial that the child get immediate medical attention.
How Can I Treat Iron Poisoning?
The best treatment for any illness, particularly substance overdose, is prevention. Iron supplements, like many other medications and supplements, are appealing to young children because they have a candy-like appearance. Childproof caps are not an effective deterrent for a determined child. Talk to your children about the dangers of taking medications without permission in simple terms that are easy for a young child to understand.
Keep iron supplements in a locked cabinet or in a place where your child can not reach them. It may also help to keep all medications and supplements in their original containers. This prevents confusion for children about the difference between candy and medicine. It also can help a parent to determine what and how much was taken if accidental ingestion does occur. If iron poisoning does occur, it is best to contact your local Poison Control Center or your physician and take your child to the emergency room right away.
Christine Bradley is currently a certified lactation educator in the Salt Lake City area. She volunteers her services as a lactation specialist through breastfeeding classes and consultations and loves to educate families about good health and nutrition. She is attending the University of Utah and is studying to become a certified nurse-midwife.
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