When to Seek Medical Care
Call your doctor, local poison control center, or go directly to the closest hospital’s emergency department if you suspect your child has swallowed iron-containing vitamins, even if your child shows no symptoms. Bring the container with you.
If you find your child among iron pills or pill containers, or your child tells you he or she swallowed pills, take the child to a hospital's emergency department.
Exams and Tests
A doctor diagnoses iron poisoning by observing your child. A normal physical exam and no symptoms for 6 hours tells the doctor that the child experienced either little poisoning or did not eat any iron-containing substances.
- If you can, tell the doctor the type of iron supplement and the number of tablets swallowed.
- The doctor may draw blood from your child to determine these levels:
- White blood cell count
- Serum glucose (blood sugar)
- The doctor may perform an x-ray of your child’s abdomen to confirm there are iron pills in the gastrointestinal tract, although sometimes they are there and not seen.
- Laboratory and imaging tests are not usually sensitive enough to detect poisoning. Some tests are also too slow to affect the diagnosis and management of iron poisoning.
Iron Poisoning Treatment
- Once the doctor makes sure your child is breathing normally, the child likely will have his or her whole bowel cleaned by drinking a strong laxative fluid.
- Severe poisonings will require IV chelation therapy—a series of IVs containing deferoxamine mesylate (Desferal), a chemical that binds to iron in a cell and is then excreted in urine.
- Deferoxamine can be administered by IV or shot, but the IV route is preferred for easier dose adjustment. A change in urine color (to a red-orange) and low blood pressure are common side effects with deferoxamine treatment.
- Usually children require no more than 24 hours of therapy.
- Orogastric lavage, or pumping of the stomach, can be considered, but it is generally only helpful if performed within 1 hour of swallowing the pills. Insertion of the tube can cause complications, and many pills may not fit through the ports of a lavage tube if they are not disintegrated.
- If ingestion of other medications is suspected, the physician may give the child activated charcoal to drink. Activated charcoal does not bind to iron but may be useful in adsorbing other medications.
Self-Care at Home
If you suspect your child has accidentally swallowed iron tablets, call your doctor or poison control center immediately. You can locate your regional poison control center phone number before an emergency by checking the Web site of the American Association of Poison Control Centers.
- Do not attempt to induce vomiting, either manually or with syrup of ipecac. This will make it more difficult to assess whether your child is truly iron toxic.
- Bring the medicine containers along with you to the hospital.