Child Survival

Keeping our children safe

E-cigarettes, despite the fact that they are designed to be a healthier alternative to smoking, have been producing an unfortunate and tragic consequence that have left many people questioning their true safety. E-liquid poisoning, especially among children, has been a topic of concern and has become a headline appearing in newspapers and on newsfeeds all over the country.

Good thing too. Since the news of e-cigarette poisoning became more widespread we have seen a sharp decline in calls to poison control centers, attributed to education and the responsibility of electronic cigarette users. However, there are still a lot of unanswered questioned about e-liquids, and their poison potential, that are worthy of further examination.

E-liquid is the primary component in e-cigarettes. It is a liquid that contains only a few ingredients that include, most notably, nicotine. While the e-liquid is not considered a generally dangerous substance when vaporized, the high concentration of nicotine that can be consumed all at once if orally ingested makes them a potentially hazardous material.

The real danger was magnified in December 2014 when a toddler lost their life as a result of the accidental consumption of a bottle of e-liquid. It’s not hard to imagine that little ones could mistake e-liquids for a tasty treat; e-liquids are small and come in appetizing looking flavors and packages that can look like candy to a young eye. This is why it is more important now than ever to understand what the real story is behind e-liquid poisonings.

Nicotine Poisoninggraph-nicotinepoisoncases

Nicotine Poisoning can affect someone in three ways, by swallowing, by inhaling or by absorbing it through the skin. E-liquid is not the only substance that can produce nicotine poisoning, other tobacco products carry this danger too. However, beginning back in late 2010 e-cigarettes, and more specifically their e-liquid, began resulting in calls to poison control centers too. While there is a certain danger in young children absorbing nicotine through topical contact on the skin, the primary concern is in the danger of young ones swallowing e-liquid.

They may look appetizing at first, but it does not take much before a child generally realizes there isn’t a need for consumption. Nicotine overdoses are rare for a lot of reasons, but the side effects are one of the major indicators to shut off the nicotine intake. In fact, Public Health England who has done extensive work on e-cigarettes and their safety, believes nicotine poisoning is truly of low risk, stating: “Serious nicotine poisoning seems normally prevented by the fact that relatively low doses of nicotine cause nausea and vomiting, which stops users from further intake.”

That being said, the amount of nicotine that can trigger a response, especially in a young child, is far smaller than what could affect a grown adult. And it does not take much nicotine to even enter the lethal dose area of concern.

How Much Nicotine is Dangerous or Fatal?

The truth about the amount of nicotine that is fatal is a large gray area. Since we have seen that the amount of nicotine available to a child in just one e-liquid bottle can result in death, it is always better to err on the side of caution when estimating the amount that constitutes a fatality risk. Especially when considering younger children, with lower weights, who do not have enough body mass in their system to fight off a nicotine overdose.

A lethal dose of nicotine has been estimated to begin at about 40 mg for an adult. More specifically, a lethal dose is estimated at anywhere from 1 to 2 mg per pound in an adult, but it is actually far less in children.  A lethal dose in children is estimated at closer to .25 mg per every pound, meaning a child who weighs 20 pounds could be exposed to a lethal dose at as little as 5 mg.  It’s important to remember while this is considered a lethal dose, it is different for everyone, and a child could easily ingest more and survive with only minor symptoms. When making estimations with someone’s life you can never be too cautious, so lethal dose estimations will always be on the lowest side.

Public Health England also note that this lethal dose estimation may be considerably low stating: “If the 10ml bottle of e-liquid was drunk, it would cause nausea and vomiting but would be unlikely to inflict serious harm. “

While some e-liquid contains no nicotine at all, those that do clearly display their nicotine strength and content right on their packaging. E-liquids generally range from 0 nicotine content to 36 mg/ml concentration. What that means is that a 10 ml bottle of e-liquid at the highest strength would contain 360 mg of solution (36 mg x 10 ml). This is some of the highest strength e-liquid, but still even a lower dose nicotine strength bottle of 12 mg/ml, would still contain more than 20 times what would be needed to be considered a lethal dose in children, if they consumed the whole bottle.

Luckily, most children are not too keen on the taste, and do not consume large enough amounts to be considered close to lethal. Even though the amount needed to be considered lethal is so small, most would not consume enough to constitute any more than some vomiting, and perhaps dizziness, which are among the most common symptoms of nicotine poisoning.

Reported Cases of Nicotine Poison

As would be imagined with the rise in the popularity of e-cigarettes, so has risen the occurrence of e-liquid poisoning cases, this is natural. Still the side effects, while unpleasant, are not often so tragic, such as the case with the child in New York. Most cases, if anything, will result with a call to a poison control center or a physician. That being said, there is still plenty of evidence that nicotine poisoning cases have increased significantly since the rise in the popularity of e-cigarettes.

The first exposure call related to an e-cigarette product came into a poison control center in September 2010; the first child exposure followed in November 2010. A gradual increase in exposure cases occurred until early 2013 when a dramatic increase in cases caused much concern among the health care and e-cigarette communities. E-cigarette poisoning related calls hit their peak in April 2014 and at that point e-liquid cases comprised 35% of all nicotine-related exposure calls. In the 2013 Annual Report of the American Association of Poison Control Centers’ National Poison Data System the explain the amount of cases related to e-cigarettes: “In children, e-cigarettes now account for roughly 25% of exposures, while in other age groups, e-cigarettes exposures have surpassed other tobacco products and account for as many as 65% of exposures.” In addition, serious cases involving children also seem less prevalent, the report continues, “E-cigarette exposures in children under age 5 have serious outcomes in only 1.9% of cases compared with 5.3% in other ages.” The report continues to account a decline in exposures since April 2014, which they believe is related to the “increased scrutiny on e-cigarettes and increased state and local regulation.”

How Does Nicotine Poisoning Stack up against Other Poison Calls

Since e-cigarettes have become more popular, the concern for e-liquid poisoning is very real. All responsible vapers know that e-liquids can pose a certain risk to little ones, and as a result keep them put away safely and securely. Even responsible electronic cigarette users can make mistakes, and when these things happen, the results can be devastating. Still, the reality of the situation is there are less nicotine poison calls as a result of e-liquid than people general realize, a mistake easy to make when every case is ripe for the headline news.  The truth is the amount of poisoning cases is way lower than most other poison calls.

Back in 2013, there were 1,543 exposures to nicotine reported to poison control centers; this includes all nicotine calls from exposure to chewing tobacco, regular cigarettes as well as e-liquids. In comparison, analgesics, basic over the counter pain medication, was responsible for just under 300,000 reported calls to the center. Alcohol was reported to be the cause of just over 70,000 calls; even common house or garden plants were responsible approximately 46,000 cases.  Even when the rise in reported e-liquid cases rose to 3,783 in 2014, the number still pales in comparison to other more common household items. In addition, with youth under 5, the most graph-nicotinevsotherpoisonprominent age group in e-cigarette liquid poisoning cases, the most common ingested items are cosmetic products or cleaning products. Both of these, depending upon the ingredients, can have disastrous consequences, just as dire as those you hear of in e-cigarette cases too.

How do We Solve the Problem?

Responsibility on behalf of the e-cigarette community has already put a major dent in this problem. Once news spread of the potential dangers of e-liquid poisoning surfaces, responsible vapers took the necessary steps to keep the potentially dangerous liquid away from little hands, and as a result we saw a drop in calls to position control centers across America. The calls have remained at a steady rate throughout 2015, however, as vaping continues to grow in popularity, but the cases of poisoning do not rise, you can assume there is a stronger presence on responsibility and education in the vaping community.

Some suggest that regulations will not only help keep vaping away from teens and adolescents, but that it will create restrictions, such as child-proof packaging, that could help curb the poisoning cases to a mere minimum. Several e-liquid manufacturers are already beginning to offer child-proof packaging to help keep nicotine poisoning cases more and more rare. With the popularity of electronic cigarettes only rising continuing education and responsibility will continue to be the best way to keep poisoning cases at bay.


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Kids, especially the younger ones are bound to get into stuff that’s potentially harmful. It doesn’t take much for a small child to fall ill. This is because they have faster metabolisms when compared to adults, which means anything that they ingest gets absorbed into the bloodstream quite rapidly. Poisonous substances are all over a typical house, from antifreeze to fertilizers, medicine and makeup. However, there are several ways through which one can enhance children’s safety around the house.

Proper Storage

All poisonous items should be kept out of children’s reach. If cabinets are accessible to children, then safety locks should be installed. Food and potential poisons should also be kept in separate cabinets. Kids could mistake the identity of products that appear similar to them.

All medicines and other products that are potentially harmful should be stored in their original containers while keeping the original labels. Expired medications should also be properly discarded. Medicines and vitamins should never be referred to as candy. Small children should not think of such substances as treats. When administering medication to children, the proper dosage directions should be followed to the letter.

One should install a carbon monoxide detector in each bedroom around the house. Carbon monoxide is an odorless, colorless gas that is produced by fuel-burning appliances and by cars in garages. It could make a child ill, even in minute concentrations that would hardly affect a grown person.

It’s also important to get the house tested for lead. This especially applies for older homes, where plumbing is likely to have been done using lead pipes. Lead is also present in paints. If a child inhales the dust produced by lead-based paints, it could build up to levels that could stunt their development, growth and intelligence.

Caution should also be taken when using cleaning products and other substances that are potentially harmful. One should never leave children alone with an open container of a substance that could cause harm when ingested. Such substances include detergents, liquid soaps and air fresheners. A small kid could be poisoned within several seconds if they ingest or come into contact with such substances.

Plants and Bugs

Lots of poison ivy plants.One also needs to learn about what plants are poisonous in their neighborhood. All houseplants should be kept out of reach. Children should also be instructed to avoid putting any part of an outdoor plant in their mouth in the absence of an adult.

It’s also important to take CPR and first aid classes. In less than 3 hours, one can learn proper and effective intervention techniques to give a fighting chance to a small child who’s come into contact with harmful substances. The toll-free poison helpline should also be put into the home phone and cellphones.

These safety precautions need to be discussed with other relatives and grandparents. The latter may have medications that could be harmful to kids. Their homes may also not be adequately childproofed. As such, one needs to have proper arrangements put in place whenever there are older relatives in the house or when they travel to their homes.

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Kids love pets! Pets are a great way to prevent loneliness, and encourage exercise in your children. They can also teach responsibility, though as the adult, you will ultimately be responsible for the pet. Although there are many choices for pets, many families decide to bring a dog into the family.
Having a dog to grow up with can be a fabulous opportunity for your children. However, not all dogs are a kid safe dog. Here are a few tips to help you select the perfect addition to your family.

1. Make a list of the traits you want in a dog

Are you looking for a dog that likes to run around outside? Do you want a large dog or a small dog? How active would your ideal dog be? Are there other animals in your home that the dog would be around at times?

What about fur—do you need a low-shed dog because of allergies? If you do not have a lot of time to devote to grooming a dog, a short-haired breed might be best.

Taking time, as a family if possible, to go over these questions will help to narrow your search for the perfect pet. Different breeds of dogs exhibit various traits, and by knowing what traits you are looking for, your search will go more smoothly.

2. Research dog breeds that meet those traits

two young puppies purebred belgian shepherds malinoisIf you are looking for a small dog due to space or a child’s fear of large dogs, you can automatically cross Labradors, Standard Poodles, and many other breeds off your list, while looking into Welsh corgis or beagles.

Likewise, if you need a dog that is more allergy friendly, a Maltese or a Bedlington terrier might be dogs to research.

As you start researching dogs, you will have your list for a starting point.

3. Find out which dogs on your list are the most family friendly

Not all dogs get along with kids. While each dog is individual, and there are always exceptions, some breeds are known for being friendly towards little ones.

Dogs who were bred to herd (like collies and Australian Shepherds) might try to herd small children, especially if they have no other outlet for their activity needs. However, they often do really well with older children.

The Newfoundland is known as the nanny dog, and might be a great choice for your family. Nevertheless, as a large dog, a good amount of space is needed for these loving dogs.

Golden Retrievers and Labradors are often recommended for families, but because of their activity level, they require a lot of time in play to burn off their energy.

French bulldogs are often compatible with older children, but would require close supervision with younger ones.
As you can see, there are many breeds of dogs out there, so spend some time doing your research before you buy.

If you cannot find a family friendly dog that meets your trait requirements, try connecting with an animal shelter. The workers there often excel at matching animals to the needs of a family. They might suggest some breeds you had not thought of yet.

4. Meet the dog face to face prior to buying

Regardless of where you buy your dog, meeting in person is essential when children are involved.

Even though there are some breeds that are known for being family friendly, every dog has a unique personality. Bring your children to meet the dog, and encourage them to spend a little time together before you bring the new pet home.

During this time, you can observe the behavior of both the animal and the children, and see if anything causes concern.

5. Teach your children to respect the dog

Even a kid safe dog can bite hard. When pushed and prodded past their breaking point, all dogs could snap. Do your best to prevent this by always supervising young children around the family dog. Leaving children and dogs alone together is asking for trouble. When you supervise, you can step-in immediately if the child starts to hurt the dog.

Teaching your child to respect animals, and treat them kindly, is an essential component of having a pet.

Bringing a dog into the home is a big responsibility. It’s also a lot of fun. Being prepared and selecting the right breed for your family will help make the transition to dog ownership go more smoothly.

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One of the hardest things to do as a parent is to take your child to the doctor. Not only does the child usually not want to go, but any good parent wants to avoid an emergency room full of contagious people. As such, it is important for the child’s health that a parent know when to take a child to the hospital and when to just keep the child home.

In general, as long as the child’s life is not in danger you may be better off waiting a little bit. This should be not be read as a general advisory to take your time getting the child to the hospital, but advice to use some judgment in the situation. A child may be able to suffer through the worst of the sickness and be perfectly fine, so there is some good reason to just keep the child home. However, a parent needs to keep an eagle eye out for potentially lethal diseases that all start with the same flu-like symptoms; what may seem like a regular childhood disease may end up being something far worse. Do not be afraid to be worried; when it comes to your child’s health a little paranoia is not a bad thing and may keep the child alive.

As a parent you need to be able to differentiate between the flu and more dangerous diseases. Flu-like symptoms include running a fever, vomiting, some coughing, and some diarrhea; as long as these are mild just worry about making the child comfortable, administer aspirin, and keep the fluids coming. It is when these symptoms become more severe that you need to start worrying. This includes a fever over 102 degrees or a cough that will not let up or has actually started turning painful. When the child cannot keep anything down or is dry heaving for long periods, the parent should definitely worry. Also be nervous if the child has to go to the bathroom a lot; this can represent a severe loss in fluids that can be life-threatening in and of itself.

Little boy in Emergency RoomThere are some other issues to look for when it comes to your child’s health. Swelling under the armpits should definitely be a cause for concern, as that is where the major lymph nodes are located; if they are enlarged it means that the body is putting forth a lot of effort to get rid of something. Watch for any bruises that cannot be explained by a known source; if your child is developing lesions it is time to head to the emergency room. If blood shows up in the stools, urine, or vomiting, or even coughing, it is past time that the child be in the emergency room.

If the symptoms remain minor, then make sure that the child is well taken care of. Keep him rested, make sure that he is getting lots of fluids to replace those that he is losing, that foods are simple and not spicy, and administer some sort of medicine. The child’s immune system is a remarkable thing, and can deal with a lot more than some parents realize. However, do not be afraid to head to the emergency room if it is needed: Your child’s health should be paramount, and not being afraid of the emergency room is part of that.

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Immunization has reduced child mortality rates significantly. For instance, immunization is responsible for the eradication of polio in the US, according to the Centers for Disease Control and Prevention (CDC). In spite of this, some parents believe that vaccines can harm their children. Here are the pros and cons of childhood vaccination:


Disease-Causing Pathogens Still Exist
Although most of the diseases that were once fatal to children have been eradicated in the developed world, the viruses and bacteria that cause the same diseases still exist. As such, failing to have your children immunized increases their risk of contracting diseases like influenza, pneumococcal disease, and human papillomavirus.

Immune system concept as an open white blood cell with a boxing glove emerging as a health care metaphor for fighting disease and infection through the natural defense of the human body.Immunization Saves Money and Time

Data from the National Foundation for Infectious Diseases (NFID) shows that the cost of treating vaccine-preventable diseases in the US exceeds $10 billion every year. This is in addition to lost workdays that can range from 5-16 days. Vaccines can help lower these financial and productivity losses. Given that vaccines are provided at no cost via federally funded programs, immunizing your child is financially sensible.

Protect Yourself and Others

Besides children, immunization benefits others like parents, a child’s siblings, and close relatives like grandparents, according to the NFID. This is because vaccine-preventable diseases can spread from young kids to people who have close contact with them. The bad news is such diseases can prove fatal or develop into serious medical conditions in the very young and the elderly. With this in mind, immunization protects your child, you, and your family. The Pediatric Academy Society says that immunization prevents 10.5 million infectious disease cases per year in the US.

Reduce the Likelihood of Premature Adult Death

Even in a developed country like the US, vaccine-preventable diseases are responsible for more fatalities than much feared diseases like breast cancer. Figures from the NFID show that vaccine-preventable diseases cause 50,000 adult deaths in the US annually. By taking your child for immunization, you will reduce a child’s likelihood of dying prematurely as an adult from vaccine-preventable diseases.

Immunization Works

Over the years, dissenting voices have surfaced questioning the efficacy of vaccines. The truth is immunization works. Data published by the American Academy of Pediatrics shows that vaccination has lowered vaccine-preventable infections by over 90%. Furthermore, the AAP says that the effectiveness of childhood vaccines in preventing diseases like mumps, tetanus, and diphtheria is high, ranging from 90-99%. As a result, children who contract vaccine-preventable diseases develop mild symptoms that are rarely fatal or could cause disabilities.


Adverse Side Effects

According to the CDC, any of the vaccines given to children in the US can cause side effects. However, side effects if any rarely cause serious problems. In fact, most adverse effects tend to be mild and last no more than a few days. This is because vaccines contain weakened strains of specific disease-causing microorganisms. Additionally, side effects generally vary from one vaccine to another. Adverse effects documented by reputable bodies such as the Institute of Medicine (IOM) and the National Academy of Sciences include:

• Protracted crying
• Brachial neuritis
• Anaphylaxis
• Deltoid bursitis
• Shock
• Chronic nervous system dysfunction
• Guillian Barre Syndrome (GBS)
• Infection caused by smallpox, measles, varicella zoster, and polio vaccine strains.
• Febrile seizure

Other possible complications, according to the CDC include fainting and dizzy spells, mild fever, fatigue, swelling at point where vaccine shot was administered, diarrhea, mild rash, runny nose, wheezing, vomiting, and inconsolable fussiness. The CDC says most of these symptoms clear within 2-3 days.


Immunization has vastly improved the health outcomes of young children who were a century or so ago at the mercy of diseases such as polio, chickenpox, measles, and whooping cough. Vaccination benefits include preventing proliferation of disease-causing microorganisms that still exist and preventing premature adult deaths. Vaccination side effects include shock, headaches, vomiting, and anaphylaxis. Nevertheless, symptoms clear within days.

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Macro shot with full ashtray with lot of butts.Cigarettes are lethal and contain many harmful chemicals such as carbon monoxide, nicotine, and other human carcinogens. If one lights up within a room, the smoke becomes detectable in the whole house in a matter of minutes. Second-hand smoke is extremely risky for small babies. It impairs their lungs, makes them prone to ear infections and raises the risk of SIDS (sudden infant death syndrome. It’s thus very important for one to safeguard their young baby from the risks associated with inhaling tobacco smoke.

Most of the chemicals that make secondhand smoke so risky stick to the surfaces of various objects within the home. This includes bottles, toys, clothes, walls, furniture and stainless steel. With time, the contaminants are released gradually back into the air, which is the same air that the baby breathes. The child could also become exposed if they put contaminated objects in their mouth or sleeps on beddings that harbor tobacco smoke pollutants. There are various ways through which one can eliminate such risks.

Quit Smoking

This applies to both the individual and anyone else in the household that smokes. Though it’s a hard habit to drop, there are various benefits to quitting. One not only enjoys a cleaner home environment, but their kids will also not be prone to respiratory illnesses. It also reduces the chance of a household fire from leftover cigarette butts.

Smoke Outside

If one can’t just help it, then they need to keep their house smoke-free by puffing outdoors. One should make it a rule never to smoke inside their home, even when it’s raining or during winter. Puffing outdoors means that the smoke naturally dissipates faster as compared to indoors. In fact, smoking inside a house is pretty similar to doing it in the car with the windows up, except that the impact is more evident in the car and more long term in the home.

One also needs to ask their guests to light up outside. It’s important to keep in mind that being one’s residence, one has the right to an environment that’s smoke-free. One thus needs to be polite but firm when letting their guests know that due to the presence of young children, smoking indoors is strictly prohibited. Babysitters should also be asked to refrain from smoking. This can prove difficult, especially when one asks their relatives or friends to babysit. One however needs to be firm for the sake of their children’s wellbeing.
One should also refrain from smoking in the car. This especially applies when there are children in the car. Even when they aren’t, one should still avoid it because the smoke residue lingers in the interior. Though some think rolling down a window would help, it may blow smoke directly into the child’s face.

Public Places

One needs to keep their children away from public places where people smoke. If one resides in an area where the law doesn’t prohibit people from smoking inside restaurants, one needs to look for establishments that enforce a no-smoking policy whenever they take their kids out to eat. This also applies for shows, concerts, entertainment places and other areas where people feel comfortable smoking. It’s important to note that even in places where smoking is prohibited indoors, most premises still allow people to puff on patios. One should thus ensure they take their kids indoors or away from tables with smokers.

Alternative Arrangements

This applies where one goes to places that allow smoking and they need to take their children there for some time. One must ensure that the kids aren’t exposed to the smoke in such environments. If this isn’t just possible, then alternative arrangements can be explored.

Additional Tips

It’s worth noting that air fresheners only work to mask the scent produced by cigarette smoke, rather than getting rid of it. Though filters work to suck up the foul odor, the harmful chemicals still linger. If one slips and smokes indoors or in the car, they need to thoroughly vacuum and clean the room or car by wiping the upholstery and leaving the windows open to allow fresh air in. All ashtrays should then be emptied and the garbage bag placed outside. The amount of cleaning effort involved may just be what convinces one that it would be easier to avoid smoking in the first place.
Shielding kids from second-hand smoke is very difficult, especially in a household that has smokers. It’s however very important to protect the kids from the harmful chemicals. In the end, it would be better to urge and support the smokers within the house to quit.

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