A small child exposed to a potentially poisonous substance causes great anxiety in parents. In South Africa, just under half of the calls to the Poisons Information Helpline relate to accidental poisoning in children under the age of 5 years. Fortunately, accidental poisoning is seldom fatal; childhood poisoning contributed only 0.3% to deaths in children under the age of 5 years for 2017 in South Africa.
Accidental poisoning is commonest in children under five years, with a peak at two years of age. At this age, children are becoming more mobile, they like to explore, and copy older children and adults, but they do not yet recognise danger.
For a pre-school child, home is the main living environment, so exposures to household substances are common. Household substances include cleaning agents such as bleaches and soaps, which can cause a local chemical (burn) injury. Cosmetics are common in the home, but unlikely to cause significant poisoning.
Common medicines that children can find at home if they are not stored safely include flu remedies, pain medication, antihistamines, tablets for heart and mental health conditions. These can cause serious poisoning in small children.
Homes such as those seen in informal settlements may have paraffin and pesticides which are easily accessible. Pesticides can be swallowed, breathed in or absorbed through the skin. Toddlers often find rat pellets and granules which have been mixed with food and put out behind cupboards and on the floor. Poor ventilation after fumigation can also result in poisoning.
Paraffin is the single most common substance to cause poisoning in children. Many parents decant paraffin into smaller juice bottles, which children confuse with water, particularly in the hot summer months when they are thirsty. Just a small sip can cause harm to the lungs resulting in shortness of breath and breathing difficulty.
Other factors may influence the risk of childhood poisoning. Family stress plays an important role. Overcrowding, moving home or holidays away from home, lack of child supervision, single or unemployed parents, and anxiety or depression in parents increases the risk of poisoning for the child. Grandparents’ homes may be particularly risky to the under-5s if adult medicines are kept in unprotected places.
Potential causes of harm are not limited to the home, as substances in the environment such as plants, mushrooms, snakes and spiders can also result in poisoning.
Assessing the risk for my child
Exposure does not necessarily mean poisoning. A substance may not be poisonous at all, or too little may have been taken to cause harm. If you suspect your child has been poisoned, find the container; identify the exact name of the substance, the amount taken, the time since exposure and note how the child is doing. Do this first, then consider calling the 24/7 Poisons Information Helpline, 0861 555 777.
What first aid can I do immediately?
Rinse the child’s mouth out with water and offer a few sips of water to drink if necessary. Forcing a child to drink a cup of milk or making them vomit is not advised as it can do more harm than good. Remove all contaminated clothes. Exposed skin should be washed thoroughly, as soon as possible, with soap under a constant stream of water that drains away, so use a shower, not a bath. Eyes should be washed with water for many minutes, with the eyelids held apart. If the child is unconscious, turn them onto their side and gently tilt the chin up (the recovery position). If a poisonous gas or smoke has been breathed in, move the child to fresh air.
What might happen at the clinic or hospital?
A child with poisoning is usually seen quickly at the clinic or hospital.
If the child has taken a lot of a particular poison, and is seen within an hour of drinking it, a mixture of charcoal and water may be given to the child to drink which binds to the poison inside the stomach; this should only be done by a health worker.
Most poisons have no antidote, so treatment is guided by symptoms (e.g. treating pain) and aimed at supporting the function of affected body organs (e.g. oxygen for difficulty in breathing, fluids if significant diarrhoea and vomiting etc). Children mostly recover well from poisoning.
How can I prevent poisoning in my home?
- Always store potential poisons out of sight and reach of children, like in a locked cupboard or in a wire cage with a padlock, high up where children can’t reach.
- Always put medicines away immediately after use.
- Remember that childproof containers are not 100% childproof.
- Never refer to medicines as sweets. It makes them more attractive to a child.
- Avoid taking medicines in front of children. They love to imitate adults, especially their parents.
- Do not share medicines.
- Do not store medicines in handbags.
- Dispose of unnecessary medicines. Unused medicines should be returned to the local clinic or pharmacy and must not be thrown away in the dustbin where children may find them.
- Be especially careful when visiting other homes, as medicines may not be stored as safely as in your home.
- Buy pesticides from shops and in proper packaging with all the warning labels. Always wear gloves when using pesticides.
- Always leave chemicals and detergents in their original containers; don’t transfer them to cooldrink bottles.
- Keep loose batteries and battery-controlled devices away from children and place a piece of sticky tape over the battery case.
- Teach your children about the dangers of eating anything from the garden.
If your child has been poisoned, call the 24/7 Poisons Information Helpline, 0861 555 777.