Iron poisoning is an extremely dangerous condition and the leading cause of death among children under six who ingest a toxic substance. Generally, iron poisoning occurs when children eat iron supplements, particularly those designed to taste good, like in kid’s vitamins. Such bottles are usually easy to open and don’t have a childproof cap. Even when they do, they do not necessarily guarantee a child cannot get the bottle open. For this reason, it is extremely important to keep all supplements containing iron far out of the reach of children.

If one suspects a child has taken iron, one should suspect iron poisoning. Accidental ingestion of iron can be fatal if not treated quickly. Thus even suspected ingestion of iron is a medical emergency. Do not induce vomiting, but instead take the child to the closest emergency room. If one has no transportation, call emergency services, since time is of the essence.

Generally iron poisoning occurs when a child takes 10 or more milligrams per 2.20 pounds (1 kg) of body weight. Thus a child weighing 60 pounds (27.21 kg) could easily suffer iron poisoning by ingesting 30 milligrams of iron. In adult pills, even a single pill, containing about 325 milligrams of iron could easily cause iron poisoning.

At the hospital, doctors watch children for symptoms of iron poisoning, unless they know for certain the child has eaten a large amount of pills. Since iron irritates the stomach, early symptoms can include vomiting and or diarrhea containing blood. Children may also become lethargic, very sleepy, or may complain of mild to severe stomach pain.

Children are usually given a strong laxative to clear iron from the stomach. Severe cases may require intravenous (IV) chelation therapy. IV chelation therapy uses the chemical deferoxamine, which binds to iron and causes it to be secreted in urine. In some cases doctors will pump the stomach through nasal gastric lavage. This is usually done only if the child is treated during the first hour after iron poisoning has occurred.

Children with iron poisoning who show no symptoms after six hours usually recover completely. Those with symptoms may need ongoing observation and treatment for several weeks. In severe cases, iron poisoning can cause liver failure two to five days after the iron was ingested. Several weeks after accidental overdose, iron poisoning may also cause scarring in the intestines.

Preventing iron poisoning is a far better option than treating it. By keeping iron away from children, one can potentially save them from serious harm. If a child does gain access to iron pills, then any suspected bottles that might have provided the iron should be brought to the hospital. Different forms of iron have different digestion rates. Liquid forms of iron may be particularly harmful since the body doesn’t have to first break down a pill to get to the iron.

Be certain all caregivers of a young child follow precautions of keeping iron and other potentially toxic substances out of reach of children. Also consider teaching children to swallow multi-vitamins that are not candied. Children of two or three can also be taught never to touch bottles of vitamins, or take vitamins from bottles without an adult’s help. However, do not trust that children will respect vitamins are off limits even if they have been taught to do so.