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11/3/2003

Flush the Ipecac, Says Pediatrics Academy

Kate Traynor

The practice of routinely administering syrup of ipecac to induce vomiting in children who have swallowed a poisonous substance should be abandoned by parents and caregivers, according to a policy statement from the American Academy of Pediatrics (AAP).

The revised statement reverses a long-standing AAP recommendation that parents keep a 1-ounce bottle of ipecac on hand to administer on the advice of a poison control center. According to AAP, the organization changed its stance on this issue because "there has never been any evidence that vomiting helps children who eat or drink something poisonous."

Because the presence of ipecac in the home can lead to its inappropriate use, AAP advised all parents who keep a bottle on hand to flush the liquid down the toilet or otherwise dispose of it.

In the statement, AAP said that administering ipecac is "treating a nondisease with a noxious intervention that is, for the most part, safe but has annoying adverse effects."

According to AAP, children who have taken ipecac may be unable to tolerate subsequent orally administered charcoal or other oral poisoning remedies that are known to be beneficial. AAP also examined the appropriateness of administering activated charcoal in the home setting but was unable to reach a consensus on this issue.

The academy stated that ipecac is often given inappropriately in the home, sometimes because parents administer the product without first checking with a health care professional. In other cases, a health care professional may recommend that parents induce vomiting even when it is not necessary. More rarely, AAP stated, ipecac may be intentionally misused by children with eating disorders or by parents or caregivers with Munchausen syndrome by proxy, a disorder in which the caretaker induces signs of illness in a child.

AAP reminded parents that the best way to deal with poisoning is to prevent it from happening in the first place. The academy recommended that parents and caregivers keep handy the telephone number of their local poison control center or the national telephone number, 800-222-1222, and seek advice immediately if a child ingests a poisonous substance.