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Sunday, October 07, 2007

Not so yummy in their tummy... a PSA

I was wandering around the kitchen the other day looking for something to eat when I noticed the jar of our youngest's multivitamins sitting on the counter.  I've always been a bit uncomfortable with pushing these vitamins, but our son is a fussy eater and, well, we wanted to spare him the embarrassment of being the only kid in his gan with scurvy or beriberi.

The reason we give him these particular vitamins is because they look and taste exactly like those gold foil-wrapped chocolate coins that you see in the weeks leading up to Hanukkah (Hanukkah gelt). Seriously, the boy would trade either of his parents for two of these chocolate coins.  Think I'm kidding?  It wouldn't even be close.

Now before any of you get all preachy on me, please take your hands off your hips and sit a spell.  You see, unless you are giving your kids cod liver oil, chopped liver and fresh fruits and vegetables EVERY SINGLE MORNING, chances are you have also resorted to rounding out their nutritional needs with a multivitamin masquerading as candy. 

Whether you give your children Flintstones Chewables or some knock-off, let's face it, your kids are taking them because they look and taste yummy... like candy. 

Here's the rub:   If your kid finds your stash of Sweet Tarts and Snickers a week before Halloween and eats every last one of them, the worst that can happen is that bedtime gets pushed back by a few hours while you wait for the little darlings to come crashing back to earth in a drooling, woozy puddle of insulin.

But if they happen to find and take a handful of those tasty multivitamins that most of you have in your homes... and you don't find out in time... it is you who will come crashing to earth as you stand staring down into the yawning, bottomless chasm that is your child's grave. 

Of course, most of the vitamins and minerals found in those innocent-looking chewables are just that; innocent.  By this I mean that if your kid takes a mega-dose of almost any of these things, their bodies will treat them like most of the other unwanted/un-desirable crap they eat and will just pass it out in a day or two.  No hard feelings... no harm done. 

But one of the common ingredients in children's multivitamins, while nutritionally important, isn't Innocent at all.  I'm talking about iron. 

Unless your kids eat a lot of Iron-rich foods (see the list below)*, either by chance or at your pediatrician's urging you are probably giving them a multivitamin containing Iron.  And while iron is an essential part of your child's nutritional intake - primarily to prevent anemia - it can be fatal in surprisingly low doses. 

For example... most children's vitamins that contain iron have between 10mg - 20mg (Flintstones Complete has 18mg).  Now, let's say a kid finds a full bottle of 100 (or worse, 250!) tablets... we're talking about ingesting anywhere between 1000mg and 5000mg of iron.  To put this in context, in very young children, death can occur after ingesting as little as 200mg of iron!**

Just in case you were wondering, here are some useful factoids I found on a few medical websites just now:

1.  If you suspect your child has taken anything containing iron (multivitamin, iron supplement, etc.), take them (the kid, not the vitamins) to the hospital immediately... there is no home remedy for iron poisoning!

2.  Do not induce vomiting with Ipecac or your finger.  Just call poison control and get the kid to a hospital.

3.  You only have about 4 hours after a kid ingests iron to perform chelation.

So getting back to my little stroll around the kitchen in search of a snack.  I picked up the jar of vitamin-enriched Hanukkah gelt and noticed that it didn't have a child-resistant cap (Note: There is no such thing as child-proof!).  As I stood looking at the laughing clown on the label and the clear depiction of yummy gold coins that our three-and-a-half year old could easily get to, my skin got very cold. 

Later, while reading up on the horrors of overdoses involving children's multivitamins, I called Zahava and asked her to check the label for iron... and sure enough it was there.  I explained what I'd found out and told her to put the jar well out of Yonah's reach (instead of on top of the counter where it had been).

All's well that ends well, right?  So why am I telling all of you?  I'm telling you because I consider myself a pretty well-informed parent, and yet I didn't know this stuff.  So now I'm giving you a small job to do.  Pass this along.

While I'm normally a stickler when it comes to the distribution of my writing, I'll gladly make an exception in this case.  Link to this post if you like... copy it onto your own sites if you prefer... email it to everyone you know who has kids.  I don't need credit... really.  Just pass it around.  If even one parent reads this and has the chilling epiphany that I just had it will be worth it.

Iron rich foods include: liver, lean red meats, seafood, beans, collard greens, spinach, and turnip greens, tofu,  broccoli, asparagus, brussel sprouts, blackstrap molasses, egg yolks and dried fruits, such as raisins, prunes, dates and apricots.

** Source

Posted by David Bogner on October 7, 2007 | Permalink

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Thank you for the warning. I had no clue about the danger of mega-doses of iron.

My wife and I thought we were responsible parents, but our resourceful four-year-old still got into the cupboard and downed an entire bottle of bubble-gum-flavored Benadryl (cough syrup). Fortunately, the tike was up front about it and came up to his mom with a frothy orange grin, announcing: "I wike med-sin!" However, he didn't much care for the ipecac "med-sin" that the Poison Control Center advised.

(By the way, in the U.S. the local Poison Control Center can always be reached at 1-800-222-1222.)

Posted by: Bob | Oct 7, 2007 2:22:05 AM

When I was around 2 1/2, I climbed up the bathroom cabinet, opened up the bottle of yummy orange flavored baby asprin, and chewed them all up. I have no idea how my sister found out what I did - all I remember is being at the hospital and thinking about how much fun it was because I got to drink a lot of orange soda.

Great advice about the vitamins, I never knew that. Btw, there are some great children vitamins on the market that have no preservatives/artificial coloring/ artificial sugars.

Posted by: jaime | Oct 7, 2007 7:52:09 AM

I'm downtown with you...I could write a book discussing and doing a little analysis of food allergies...and other little known problems with pills (over the counter drugs) out of a bottle. At least, you got in from the get-go. I do not have a four year old son, but I do have a one year old puppy...and I have to watch him like he is a human. If he can find it...he can open it. I'm not comparing your young son to a dog, but the point is:

Most people have no clue.

This is definitely not the post to ask this question....but I'm shameless... what do you truly believe will happen with Iran? Just curious...you are right in the middle of it.

Posted by: Sam | Oct 7, 2007 8:11:33 AM

Bob... As I mentioned in this post, a well respected physician (an anesthesiologist listed in my blogroll under 'book of joe') feels that Benadryl is probably the best possible sleeping aid since it is not addictive and has little or no risks involved in taking too much. So you got off pretty lucky on that score. :-)

jaime... I also loved the orange baby aspirin of my youth, but I don't think I ever tried to OD on them. I think that the reason more parents don't have problems such as you described these days is because the awareness/fear of Reyes Syndrome has all but banished children's aspirin from most homes with very young children.

Sam... Since you mentioned dogs, I should point out to you pet owners that both grapes and chocolate can be fatal to dogs (for different reasons) if they get enough of them. As to your follow-up question... since you asked, I think the world will drag its feet and do the diplomacy dance until it is too late and Israel will have no choice but to attack them. You asked.

Posted by: treppenwitz | Oct 7, 2007 8:29:42 AM

In one of my education courses at Barnard, we had to make a mock lesson about the dangers of drug abuse. I remember that one of my peers, who was training to become an elementary school teacher, made a terrific lesson for Grade 1 explaining the difference between medicine and candy, with pictures showing how alike they look. I certainly filed that information away in my mind for the day I ever have kids!

Posted by: The Other Sarah B | Oct 7, 2007 9:43:21 AM

Thanks for the heads-up!

Those of us of a certain age might recall an ad explaining some of this to us...

Posted by: efrex | Oct 7, 2007 10:36:30 AM

You see, one of the things that's been bothering and shocking me for a long time is that we think we have to rely on dietary supplements even for our children and when they're healthy.
My observation is that people in the US craze out about the importance of dietary supplements; I noticed it when I compared directions for US supplement doses with the amount doctors suggest here in Germany. It's crazy. Unless we're severely weakened or sick, our bodies can't even fully put to use all of the stuff we're swallowing.
We live in societies with nutrition overflow and tons of overproduce going down the drain to comply with mad quotas, and we can't be arsed to make intelligent use of it and instead rely on pills.

Why is our relationship with food such a sick one?

Posted by: a. | Oct 7, 2007 12:03:43 PM

a. -- ordinarily I would agree with you and would submit that many of the vitamin supplements could prove more hazardous than helpful. However, in Yonah's case, due to his rather restrictive eating habits (can NOT stress how understated that sentiment is) and the fact that he takes medication which further interferes with his body's ability to absorb nutrients, we opted to follow our physician's strong recommendation (read: order) to supplement his diet with vitamins.

His diet regimen is self-imposed. We offer quite the variety of foods on a daily basis. However, between simply being 3.5 years old (read: naturally picky about foods like any good toddler) and his sensory issues (read: Rain Man), the likelihood of his diet repertoire changing in the near future has me thankful that this nutritional boost is available.

His dislikes could fill an encyclopedic tome, his likes are simple: cheerios, grapes, cucumbers, peanutbutter and crackers, chummus, pizza, string cheese, chicken schnitzel, hotdogs, french fries, chatifim (bamba, bisli, and the like), chocolate milk, applejuice, apples, ketchup, cous-cous/rice, and water. Full stop. Nothing else.

Considering most of these options are already in the "better living through chemistry" department, the vitamins don't seem so bad, now do they?!

Posted by: zahava | Oct 7, 2007 1:23:28 PM

Ooops! Forgot his favorite food group: chocolate! :-)

Posted by: zahava | Oct 7, 2007 1:29:11 PM

Anyone who likes pizza is guaranteed a place in olam habah. No really, there is a special gemara about it.

Posted by: Jack | Oct 7, 2007 5:43:05 PM

i found out about iron poisoning from an episode of e.r. -- it was one of the scariest episodes since those kiddie vitamins seeem so innocuous. i immediately put the iron-rich prenatal vitamins i was taking way up high out of everyone's reach. scary stuff.

Posted by: nikki | Oct 7, 2007 7:25:58 PM

Unrelated - your PAYPAL button for Pina Chama is not working.

Posted by: Holly | Oct 7, 2007 9:22:06 PM

Should your kids take vitamins, period? A good diet provides all the vitamins anyone needs (or how did we survive for the millions of years before we invented vitamins in pill form?). Vitamins are almost exclusively made in China. If you trust China to make stuff that you put in your own kids, you're a braver and more trusting person than I am.

Posted by: evariste | Oct 7, 2007 11:25:22 PM

Thanks for the heads-up on this. The only vitamins that I sometimes give my kids are the chewy vitamin C things - in the winter, to boost their immunity (or to make myself feel better!)

Zahava - have you tried giving him chalva? It is sweet as hell but has iron in it (techina is even better, but I can see how Yona might not go for it).

Posted by: westbankmama | Oct 8, 2007 8:47:23 AM

Wow! Thanks for the warning. As the father of a two-year-old who gets into EVERYTHING, it's good to know these things.
BTW - regarding Iran - this week's Newsweek ran a cover article basically taking it as an article of faith that Israel will eventually bomb Iran's nuclear facility. We should save a copy of it for when they condemn us after the fact. For all the good it'll do...

Posted by: psachya | Oct 8, 2007 8:51:20 AM

The Other Sarah B... If you think about it, it is a tight wire that manufacturers have to walk, between making vitamins attractive/palatable to kids without making them too attractive/palatable.

efrex... Where was I? I must have been asleep that day. :-)

a. ... While I agree that our relationship with food is completely broken, I do feel there is a place for vitamin supplements, especially where kids, adolescents and pregnant/nursing women are concerned. The elderly also require certain supplements that they can't always get from foods. It really isn't so simple.

zahava... Thanks for compiling the list. Seeing it written out like that I am amazed that he eats as many things as he does! :-)

Jack... Let's not forget the biblical commandment to provide Jeff's Sausages to distant friends at the end of baseball season. :-)

nikki... Isn't it amazing what stuff we pick up from shows like ER. If you think about it, it is an awesome responsibility to the show's writers to make sure they are giving the public accurate information.

Holly... Please try again. If it still doesn't work, try the orange and gray 'spoil soldiers' button on my sidebar. thanks in advance for your donation.

evariste... There are two issues in your first statement. Fist and foremost is the difficulty of getting kids to eat all the healthy foods you put in front of them (think of the old saying about 'you can lead a horse to water...'). But even if they do eat all the good foods you put in front of them, some children have difficulty absorbing all the iron they need. My wife is a good example of this... she has been anemic for most of her life despite eating all the right foods. Second, we may have survived for all these years, but the average lifespan back then was not very promising.

westbankmama... Oooh, good idea, although we may have to hide the Halvah from Zahava. :-)

psachya... They conveniently forget what it would have been like facing a nuclear-armed Sadam if Israel hadn't done the world's dirty work back in the early 80s.

Posted by: treppenwitz | Oct 8, 2007 9:12:44 AM

Though this post is about vitamins, there is an excellent new Drug awareness ad campaign directed to parents that I am reminded of, when reading this post. It's drugfree.org and in the commercial are children reciting a list of drugs in street slang. It so scary to realize how far removed many of us parents are when it comes to what's out there. Not only in with the "safe drugs" that we allow, but the illegal drugs as well.

Posted by: Jaime | Oct 11, 2007 3:22:59 PM

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