Poison Control and Child Safety

Poison Control and Child Safety

You experience abject fear and relentless guilt.

The former grabs you when you realize that your kid has swallowed or drunk something potentially dangerous.  What is it?  When did this happen?  Could she die?

Then the latter hits.  How could I be such a god-forsaken, ignorant, lazy fool for letting this happen?

So what do I do?  Who do I call?  911?  Not necessarily, because the people that they’ll call are at a regional Poison Control Center.

So Just What Is Poison Control?

As a parent, your first introduction to them is probably through the bright green “Mr. Yuk” stickers that came from your pediatrician or maternity ward.  And if you’re paying attention – and fortunate – that will be your last

Created to provide toxicology information for medical emergencies, there are more than 60 Poison Control Centers in the country and each is responsible for a particular region.  Each is staffed by trained specialists, frequently nurses or pharmacists, and has access to a computerized database of natural and toxicological substances.  It is surprising that there is no automatic government funding for these Centers.  Each must obtain its individual funding separately through applications for federal and state grants, medical center affiliations and individual donations.

What You Need to Know About Poisons and Your Child

Trust me, a poisoning event – either through chemical or natural substances – can happen to your child.  It’s happened to my family twice in 13 years.

First, there is only one phone number for all the Centers and it isn’t 911.  Mark this:

                1-800-222-1222

Several years ago, the Centers adopted phone technology which reads the incoming area code and automatically routes the call to the appropriate Poison Control Center.  While all have the same toxicology information available, each has a better grasp of what local hospitals and resources are available in their particular region.

According to Dr. Allison Muller, Clinical Director of the Poison Control Center at the Children’s Hospital of Philadelphia, her center alone averages 80,000 exposure calls annually for the region of Delaware and Eastern Pennsylvania.  In her experience at the Children’s Hospital of Philadelphia, there are three key things for parents to understand.

First, do not underestimate the speed and resourcefulness of your small child.  A toddler is eminently able to reach high places and enter remote cabinets when he puts his mind to it.  Having all of the prescriptions and other medications in a separate cabinet simply isn’t sufficient.

Second, even a child-proof/resistant cap can be beaten and might only provide a few minutes of difficulty before your child is into it.  Knowing these facts, Dr. Muller keeps her home medicines stored in a locked toolbox.

Third, keep all liquids in their original marked containers and don’t store excess of refills in other containers.  Dr. Muller cited a call in which a toddler was unwittingly served dilute windshield washer fluid as a snack drink when it was stored in a juice bottle and inadvertently placed in the refrigerator.  The child fortunately survived.

So What Should You Expect When You Call Poison Control?

Most bottle warnings tell you to either contact your physician or Poison Control if the contents are ingested.  According to Dr. Muller, a Doctor of Pharmacy and toxicologist, the first call should be to the Poison Control Center as time is essential and you’re already there with the bottle or material.  If however, you believe that immediate medical attention is required, call 911.

You can expect such questions as your child’s age and condition at the moment, what was ingested, when it was ingested and how much was ingested.  Dr. Muller outlined a scenario for a child who drank from an adult formula Dimetapp bottle.

Q:  How much did she drink?

A:  I don’t know.

Q:  Okay, what’s the size of the bottle?  How much does it contain at purchase?

A:  The label says 4 ounces.

Q:  How much is in the bottle now?

A:  Umm, maybe a third?

Q:  Alright then, how much was in it to begin with?

A:  I don’t know.  I’m not sure.

Q:  I want you to add a teaspoon of water to the bottle – count the number that it takes – to bring the level back to where you thought it was.

A:  (After a pause) Five teaspoons.

With this, the specialist can estimate how much the child drank and outline whatever course of action is appropriate.  If you’re directed to a physician or hospital, be sure to take along the bottle for the staff to review.

Practical Home Tips for Kids and Poison Safety

1.       Keep all medications secured in a locked place.

2.       Keep all liquids in their original containers.

3.       Know what’s planted in your yard.

       a.       If you plant something, keep the identifying tag available in case it’s eaten.

       b.      If you move into a new home and have small children, identify what’s planted in your yard.  I removed a vine plant growing from under a corner bush after a neighbor identified it as Nightshade.

4.        Let  your kids only use paints marked as non-toxic and keep them separate from adult paints.  Keep model-kit paints (oil-based) and supplies in a separate box from other children’s art supplies.

5.       If you’re using cleaning supplies and are called away to the door or phone, take your child with you or gate them away from the supplies.  Never leave a child alone with cleaning supplies.

Watch, watch, watch.  And good luck.

Thanks to Dr. Allison Muller, Director of the Poison Control Center, Childrens’ Hospital of Philadelphia, for her assistance.

For further information, visit the Childrens’ Hospital of Philadelphia Poison Control site at www.poisoncontrol.chop.edu

Introducing your Child to Solid Food

Junior, this is food.  Food, this is Junior.  Knock yourself out, kid. 

Introducing your baby to solid foods involves more thought and planning than just tossing a diced Italian sub on the high chair.  It is a months-long process in which the child learns how to eat solid foods and you learn what foods he can’t tolerate.  Surprisingly, one of your best tools here is a pencil and notebook or calendar as you monitor what he eats and how he responds to it.  You are, in a sense, controlling the variables in something akin to a science project. 

Why Do I Have to Do This?

The body can be allergic to certain types of food and react in a number of unpleasant ways to them.  The reaction severity can range from mild skin rashes to diarrhea to breathing problems requiring a full-blown 911 call, although this last is a rare possibility.  Foods which most commonly cause allergic reactions are milk (lactose intolerance), peanuts, wheat products (gluten intolerance) and shellfish.  Physicians will advise you to hold off on those items until later.

You introduce one particular food at a time so that you can monitor the effect of each on your child and if there is a reaction, note that food as allergenic.

How Do I Know that He’s Ready for Solid Foods?

From birth, Junior will be taking either breast milk or formula and he will continue to do so even after even starting solid foods.  It is a weaning process which commences when:

1.        He doubles his body weight;

2.       He has sufficient neck control to hold his head steady;

3.       He has enough control of his tongue that he doesn’t just push food out of his mouth (extrusion). 

4.       He can sit upright either in a high-chair or on your lap;

5.       He wants the pretzel that you’re munching while you’re reading this.


This can occur anywhere from 4 to 6 months of age and when these happen, you can take it as a sign that he’s ready to go.

What Reactions Indicate a Food Allergy?

An allergic reaction to a particular food is typically noticeable within several seconds to several minutes, although it could occur within several hours afterwards.  Here are symptoms that might appear:

1.        Reddened or flushed skin, hives or itching;

2.       Diarrhea, upset stomach/vomiting;

3.       Sniffles/running nose (aka the Green Elevens), congestion, sneezing or difficulty breathing;

4.       Anaphylaxis, a condition in which the throat and airways start swelling and lead to breathing problems.  If you suspect anaphylaxis, immediately contact your physician or 911.

So How Do We Start?

There are some foods that physicians and dietitians advise you to stay away from until the child is older.  These are:

1.        Milk and dairy products until about one year of age;

2.       Eggs and egg products until about two years of age;

3.       Peanuts, other nuts, fish/shellfish and honey until about three years of age.

Ask yourself and your mate if there is any family history of food allergies and if so, share that with your physician.  She will recommend that these particular foods not be introduced until late in the hopes of keeping your child from developing sensitivity to that food.

When he has reached the solids threshold, start with a single helping of rice cereal one a day.  The rice cereal is free of gluten, a protein found in wheat and a potentially allergenic substance.  Mix the dry cereal, available in the grocery’s Baby Food section, with a small amount of formula, breast milk or warm water.  Then feed it with a rubber tipped spoon to protect your child’s gums.  Continue the feeding until he lets you know he’s done by turning his head away or pushing on the spoon.  One of my children was notable for a particular “get that crap out of my face” look.  You’ll increase the number of feedings – up to three – each day as the weeks continue until he is taking cereal with every feeding; once regular food is established, you can stop the cereal.

After several days of cereal, you can start with a highly strained vegetable.  Again, try it for about three to five days to see if there is any allergic reaction and if none is found, note it as okay and move onto another food.  After each new food has been tried and found to be okay, it can become one of the stable of acceptable foods for meals so that there are additional choices for meals.  If there is a problem, you can link it to the new food being tried.

There is no set way of determining what food to introduce when but you might want to consider starting with some green vegetables instead of fruits and sweet potato.  Some kids get hooked on the sweet flavor early and then snub the plainer foods.  Since your memory can suffer from the pace and confusion of caring for a baby, be sure to use the calendar or pad for brief notes so that you can keep things straight.

As the first year passes, you can start shifting from strained to solid foods.  You must cut the solid foods into very small pieces so that the child doesn’t choke as he eats.  His esophagus is very small and there is a choking hazard.  By the end of the first year, he can be off of breast milk/formula at meals as well as the rice cereal.  A typical lunch for my kids at this point consisted of finely diced meat (hot dog, for instance), grapes sliced into quarters and carrots microwaved for softness (but then cooled before serving).

Remember that even as he takes in more solid foods, he may still need breast milk or formula until he’s about one year of age.  The general format of a meal in the latter part of his first year would be a small amount of formula or breast milk, followed by cereal and topped off with the food.  As a practical note for Dads, check with the new Mom before you introduce a new type of solid food since it can be a memorable event.  I was frankly ticked off to return from a restroom to the restaurant table to find that eldest had had her first bite of solid food while I was away.

Even if science wasn’t your best subject, keeping things consistent is the key.  Remember that and you should have no problem.

I’d Like to Help Out

I’d like to help out more around the house while I’m here, but I’m not sure what I’m supposed to do.

                                    –   Father of three who works night shift while wife works days

Throw me a frickin’ bone here, people!

                                    –    Doctor Evil

Women and society say that families need engaged fathers who actively participate in their family life.  But men are apparently caught in the trap of  trying to make that happen with few, if any, guides on how to how to pull it off. 

A recent study released by the Council on Contemporary Families finds that the amount of family-oriented work (housework/childcare) performed by men increased significantly over the past 40 years.  Men doubled their housework contribution from 15 to 30% – not where most wives want it, but a significant change – and tripled their time spent on actual childcare. 

Despite the positive results shown in the study, fathers are hamstrung by a public perception as a borderline idiot.  This is even demonstrated in the AP article about the study:

            “The average dad has gradually been getting better about picking himself up off the sofa and pitching in, according to a new report in which a psychologist suggests the payoff for doing more chores could be more sex.”

And nowhere in the AP article is sex even mentioned.

Granted, most guys don’t frequent the family section of your neighborhood bookstore, but there is a huge imbalance between resources available for mothers and those available for fathers.  A brief review of the Barnes/Noble magazine rack showed     magazines for mothers with none for fathers.  And a like inspection of the family section shows an imbalance as well.

The public image of the father has also taken a drastic hit in the preceding 30 years.   Starting with Archie Bunker, the typical media father is a loudmouthed, (c)rude, boor who doesn’t know how to relate to his family, even if he is a closet sentimentalist.  There is the occasional Reverend Camden from 7th Heaven, but he’s offset by Al Bundy, Homer Simpson and Peter Griffin.

If you want men to take an even greater role in their family’s life, try giving them the resources and public support that they need.  Please, throw them a frickin’ bone, huh?

Henry Kissinger, Father

I cut my earliest political and social teeth during the latter Vietnam and Watergate years.  Wrestling with those reliable old Russians – and arguing with the North Vietnamese – was Henry Kissinger.  He cut an amazingly long shadow for a guy the size of Golem and his occasional commentaries today are still run in major publications.

But I was taken aback recently to realize that Henry was secretly giving me lessons in disciplining future children during all those years.  Henry pursued diplomatic strategies that are actually usable with the kids, especially when they’re being particularly recalcitrant.  I now ask myself, what would Henry do?  Here are three of his favorites that I regularly employ.

Trust but verify.  This trite little phrase was used by Henry to highlight his plan for dealing with the Soviet Union about missile reduction.  It’s also effective in teaching little kids about truth-telling.

                Dad:  If you want to watch a little TV before bedtime, go brush your teeth.

                Junior:  Okay, Dad.

                Dad (After watching Junior run past in 10 seconds):  Did you brush like I asked?

                Junior (heading for the sofa):  Sure, yeah.

                Dad:  Really?  Are you sure?

                Junior:  Yeah, Dad.  Uh-huh.

                Dad:  So…okay, son.

Henry would follow through a bit more than Dad.

                Henry:  If you want to watch a little TV before bedtime, go brush your teeth.

                Junior:  Okay, Henry.

                Henry (after watching Junior run past in 10 seconds):  Did you brush as I requested?

                Junior (heading for the sofa):  Sure, yeah.

                Henry:  Really?  Are you zhure?

                Junior:  Yeah, Henry.  Uh-huh.

                Henry:  Zo…iff I zend in a team of Army inzhpectors, they vill find a vet brush und zhpit in ze zink?

J                unior:  Uh…lemme check.  Oh yeah, I forgot.  Be right back!

Follow this principle from an early stage and he’ll learn to be truthful with you – or at least improve his ability to create stage scenery.

Bomb them back to the negotiating table.  As they age, they’ll sometimes not want to  talk to you and will adopt various ruses to avoid it.  These include the thousand-yard stare, the phantom phone-ring, the oops, gotta study-big test!, or the patented DeNiro you talkin’ to me?  Don’t let the frustration thwart you, because you still have the leverage:  cash, car keys and control of the cell-phone’s family plan.

                Dad:  Honey, we need to talk about the upcoming deadline. 

                Honey:  (engages in the stare, wondering if Dad realizes that one nostril is too big).

                Dad:  Honey, about the deadline…

                Honey:  Wait a sec, Dad, I think the phone’s ringing.

                Dad:  Hey!  (chasing her upstairs)  The deadline is almost here!

                Honey:  I’m coming, I’m coming!  (Dad’s note:  Do you think that they actually hear her?)

Here’s how Henry would approach the situation.

                Henry:  Ve need to discuss your approaching deadline.

                Honey:  (engages in the stare, wondering if Henry realizes that his one nostril is twice as big as both of yours combined).

                Henry:  Iff you do not talk to me now, you vill loose your cellphone prifileges.

                Honey:  So about that deadline…

See how Henry sets the stage with no loving nickname?  He’s Henry and he means business, dammit!  He refuses the dodge and goes right to the bomb.  BOOM!  And she’s back to the table.

Mutual Assured Destruction

This tactic assumes that you have a track record of following through with your consequences.  Do you think that Henry would have a problem with his kid?  He had the Air Force plaster the Ho Chi Minh trail just to show the North Vietnamese negotiators that he preferred the Waterford goblets to the standard Paris hotel water glasses.  Likewise, did you ever hear of Harry Truman having a problem with his only child, Margaret?  He said he would use the A-bomb and he did.  Twice.  I bet Margaret’s behavior seriously improved after Nagasaki.

Likewise, use it sparingly and only for important situations. 

                Dad:  Son, this family shot really means something to your mom, so none of that “Rock-on” posing crap for the photo.  Okay?

                Son:  Aw, Da-a-d.  It’s only a picture, okay?

                Dad:  I’m serious.  Show some respect to your mother, alright?  It’s important to her.

                Son:  Jee-e-z, Dad.  Come on.  What do you think I am?

                Dad:  Alright, son.  Just remember…

                Photographer:  Everyone ready?  Here it comes…say “cheese”!

                Son:  Rawck on! (deedle-deedle-deedle).

                Dad:  UURRGHHHH!!!!  BILLY!!!!

Here’s how Henry would handle it with the “Mutual Assured Destruction” technique.

                Henry:  Villiam, your mother zinks zis photo iss important.  None of the typical shtuff, Ja?

                Son:  Aw, Henry.  It’s only a picture, okay?

                Henry:  I am fery zerious now.  Zhow zome reshpect to your mother, Ja?

                Son:  Jee-e-z, Henry.  Come on.  What do you think I am?

                Henry:  Sehr gute.  Just remember…I can permunently crazh your vebsite on Myzhpace.  Ja?

                Photographer:  Everyone ready?  Here it comes…say “cheese”!

                Son:  Cheese!

                Henry:  Zank you, Villie.

Despite having a lot of babes in his prime years – seriously – Henry didn’t have any babies.  And that’s a shame since he probably would’ve been an effective father.  I’m just glad that he wasn’t mine, Ja?

A First Year Timetable for Dads – What to Expect When You Don’t Know What to Expect

Frequent sleep deprivation and integrating a new child into your life can result in a first year that’s a complete blur.  If you’re like the rest of us, you’ll probably wonder what the first year’s milestones are and whether Junior is on track.  So here’s a brief list of the first year milestones that ought to help.
 
Remember that this is comprised of averages and that there is likely to be some differences between children.  For example, the occasional child is born with one or more teeth or your daughter may not choose to crawl until later.  One friend’s son was eating cut-up steak at two months.  Be patient and if you have questions, talk to your mate or contact your pediatrician.
 
You should also note that some of these milestones build upon one another.  For instance, holding the head up and sitting up without support all build upon the basic control of the neck muscles.  Happy reading and hang on tight!

Event Timeframe
1st stool (Meconium*) 1st day
1st Well-baby doctor visit 2nd day
2nd Well-baby doctor visit 4th day
Umbilical cord falls off 2 weeks
Well-baby checkup 1 month
1st time clearly smiling at you 1 month
Lift head up 1 month
Well-baby checkup 2 months
1st sex with new mom (theory) 3 months
1st tooth 3 months
Able to grasp/lift light objects 3 – 4 months
Well-baby checkup 4 months
Hold head up 4 months
Turn over 4 months
1st pulling up 4 months
Well-baby checkup 6 months
1st time clearly seeing you 6 months
Stops needing breast milk/formula 6 months
1st time solid foods introduced 6 months
1st time crawling 7 – 8 months
1st time walking 10 – 12 months
1st Dental visit 1 year
Well-baby checkup 1 year
* Meconium is not a gladiator or fuel for a Federation Starship. It is the term for the thick, tarry substance that constitutes your child’s first stool and is the remains of what was in his intestines/colon while he was in utero. Despite the rather nasty look and concept, it doesn’t smell – that comes later.