If you have a bottle of ipecac syrup in your home, throw it out, says a new policy statement by the American Academy of Pediatrics (AAP). Ipecac syrup had long been recommended by the AAP and other authorities to induce vomiting in children who have swallowed poison or accidentally overdosed on medication.

This change may come as a surprise to parents, because ipecac syrup has been a staple in medicine cabinets across the country since 1965, when it first became available without a prescription. But the AAP's reversal comes on the heels of several findings.

For one thing, poisoning deaths have decreased dramatically over the last 50 years - from about 500 to 25 annually - mainly due to poison prevention efforts, including safer medications and child-resistant packaging. Rather than rely on ipecac for a false sense of security, parents should continue to focus on prevention in the home and should keep the nationwide number for poison control handy: (800) 222-1222.

Second, studies have shown that ipecac doesn't work for everyone, doesn't guarantee a good outcome, and doesn't prevent a trip to the emergency room. Children who swallow poison still need to go to the hospital for medical evaluation and for other measures to neutralize or remove the poison from their bodies. With most young children, this is done by giving a dose of activated charcoal through a nasogastric tube (a tube inserted down the nose and into the stomach). Charcoal is a much more effective and predictable way to prevent the body from absorbing a toxic substance, and its action may be hindered if ipecac is given first.

There's also been some concern over the improper use of ipecac in the home. Made from a plant root, ipecac causes a person to throw up within 20 minutes by stimulating the central nervous system and the stomach, so it's commonly abused by people with bulimia and other eating disorders to purge themselves of food. Less commonly, it has also been associated with Munchausen by proxy syndrome - a rare condition in which caregivers purposely sicken children in order to seek medical attention. Abuse of ipecac can lead to heart problems and even death.

Finally, there are some poisoning situations where vomiting is not recommended. Certain household chemicals - such as cleaning supplies, gasoline, and turpentine - are caustic or otherwise more toxic if they are vomited. In these cases (and others where parents aren't sure what poison their child has swallowed), ipecac may not only be ineffective but also harmful.

The safest thing to do is to discard your family's bottle of ipecac syrup, and follow these tips to make sure your child isn't one of the 1.2 million children younger than 6 who ingest potentially poisonous substances every year:

• Store all medications, vitamins, cleaning supplies, and alcoholic drinks in high (preferably locked) cabinets. Cosmetics and toiletries should also be kept far from children's reach.
• Never tell a child that medicine is "candy."
• Take special precautions when you have houseguests. Be sure their medications are far from reach, preferably locked in one of their bags.
• Don't rely on packaging to protect your children. Child-resistant does not mean childproof.
• Keep medications and cleaning supplies in their original containers - not in old soda bottles or containers that were once used for food.
• While cleaning or using household chemicals, never leave the bottles unattended if a small child is present. Similarly, take special care with alcohol during parties - guests may not be conscious of where they've left their drinks.
• Keep rat poison or roach powders off the floors of your home.
• Keep hazardous automotive and gardening products in a securely locked area in your garage.
• Learn all the names of the plants in your house, and remove any that could be toxic.
• Discard used button-cell batteries safely, and store any unused ones far from children's reach (alkaline substances are poisonous).

If you suspect that your child has ingested a toxic substance, call poison control right away at (800) 222-1222 and get advice from a trained professional. If your child is having trouble breathing or is unconscious, call 911.

 Bundles of Joy recommends consulting your pediatrician or other healthcare official with further questions.

This article orginally appeared at http://websrv02.kidshealth.org/breaking_news/ipecac.html and was reviewed by Steven Dowshen, MD in November 2003.  KidsHealth is a project of The Nemours Foundation.  Visit Nemours.org to find out more about The Nemours Foundation and its health facilities for children.