Keeping Children Safe


If you keep an EpiPen Jr (epinephrine) auto-injector on hand in case a child has a severe allergic reaction, you need to know about the risk of cutting a child while the needle is under the skin if he or she moves during the injection. An EpiPen Jr auto-injector is a disposable automatic injection device filled with 1 dose of epinephrine. When the orange tip is pressed against a child's outer thigh until it "clicks" and then held there for 10 seconds, the dose is automatically delivered. Prompt treatment of severe allergic reactions in the home and community can be lifesaving and has resulted in better survival rates and less long-term effects. Most often, auto-injectors are used successfully without complications. But two children recently sustained cuts on their legs when using the EpiPen Jr.

People may not realize that an infected mother can pass on the hepatitis B virus to her newborn infant at birth. Hepatitis B is a serious, contagious disease caused by a virus that attacks the liver. According to the Centers for Disease Control and Prevention (CDC), the hepatitis B virus can cause lifelong infection, leading to cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.

Many parents like to rub numbing medications on their baby’s gums to treat the discomfort of teething. Products for this purpose, called topical anesthetics, are available for purchase over the counter (OTC). Examples include Anbesol and Orajel. There are also prescription products (e.g., viscous lidocaine) that doctors sometimes recommend. However, because of safety concerns, we do not recommend that babies receive medicines containing topical anesthetics.

For many of us, the holidays will include joyous family gatherings. However, your holiday cheer will quickly fade if a child at your family gathering gets into unsecured medicines and requires a trip to the emergency department (ED). Don’t let your guard down—it can happen to a child you love. In the US, every 10 minutes a child younger than 6 years is taken to an ED to be treated for a medicine poisoning.1 Tragically, about 40 children younger than 5 years die from accidental poisonings each year—three-quarters due to medicine.2 In recent years, childhood poisonings have grown at an alarming rate.

Camphorated phenol is an antiseptic liquid containing camphor and phenol. These two ingredients, used in combination, are often used to treat pain and itching associated with conditions such as minor burns, cold sores, insect bites, itching skin and mild sunburn. Camphorated phenol is a liquid that must only be applied directly to the skin. Ingesting camphorated phenol can cause toxicity, especially in children.

In March 2013, we described a case in which a number of 9- and 10-year old children were taken to hospitals after they had ingested what they thought were breath mints but were actually nicotine replacement lozenges. The “mints” had been brought to school by a classmate. Unfortunately, we have learned of a similar incident, this time involving melatonin strips.

In February, the Chicago Sun Times reported that 16 elementary school children had been taken to local hospitals with a sudden illness. The children were 9- and 10-year olds who began vomiting after eating “mints” given to them by another classmate. It was later found that these “mints” were actually nicotine-replacement lozenges, called NiQuitin Minis (Figure 1 on page 3). (NiQuitin is a product from the United Kingdom that is sold online; however, the Nicorette brand made in the US has a similar product.) The classmate found the lozenges at home and brought them to school to share.

The Food and Drug Administration (FDA) is  alerting patients, caregivers, and healthcare professionals of the importance of appropriate storage, use, application, and disposal of fentanyl patches (including Duragesic and generic products) to prevent potential life-threatening harm from accidental exposure to the active ingredient, fentanyl.

Here is a mother’s blog, originally submitted to JNJParents, that caregivers of small children might find of interest. The author discusses a number of “safety gaps” when keeping medicines away from curious children.

Infants who are breastfed or partially breastfed should receive a daily supplement of vitamin D starting in the first few days of life. Breast milk has only 25 units of vitamin D per liter (that’s roughly a quart or about 32 ounces). The American Academy of Pediatrics recommends a daily dose of 400 units of vitamin D for infants. Infants who drink less than a liter of formula also may need a lower dose of a vitamin D supplement. Although formula is fortified with vitamin D, enough may not be consumed each day to get the total recommended dose of 400 units.

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