• First the pet food, now infant formula?

    Melamine in a nutshell.

    Melamine is a substance that can be combined with other chemicals to form a melamine resin which is a durable type of plastic. The end products of its use include counter-tops, glues, flame retardants, and adhesives. Melamine has been indicted as the agent responsible for the cases of renal failure and deaths related to pet foods in 2007 and more recently with the contamination of milk products and infant formula in China. Suggestions have been made that the melamine was used to elevate the protein measurements of these products.

    Most testing done to measure the protein in a product actually measures the amount of nitrogen. Since protein is one of the few foods that contain nitrogen, the indirect nitrogen test usually correlates with the concentration of protein in the product. Addition of melamine to products used for animal or human consumption increases the measurement of crude protein as the nitrogen in melamine is measured as protein. Additional testing would be needed to measure the actual amount of protein itself and identify the contaminant.

    When the melamine is combined with another product, cyanuric acid, another chemical that can cause kidney stones is formed. This insoluble melamine cyanurate may lead to renal failure, particularly in cats. In China, infants who were given the contaminated formula have had kidney stones and some have had kidney failure. Infant deaths have occurred.

    Currently, infant formulas made in the United States do not have any of the contaminated products. Caution should be used with the use of food products that are imported from China and are sold on side markets that are not as vigilant about food recalls. The eating of food from an animal that had melamine in their diet does not have an obvious risk to humans.

  • Arsenic in Fruit Juice?

    Sometimes it’s so confusing being a parent! You want to make sure your kids are safe and healthy, so you try to make the best decisions you can. And then something comes up that makes you scratch your head and worry that what you thought was good for your kids may not be.

    Take fruit juices, for example.

    A study by Consumer Reports found levels of arsenic above the federal limit of 10 parts per billion for drinking water in 10 percent of the juice products it sampled.

    These reports understandably have caused many parents to be concerned and confused!

    According to the experts at Americas 55 poison centers, there are two types of arsenic: organic, which occurs naturally in air, soil and water; and inorganic, which can be found in pesticides, for example. Of the two types, the inorganic form is of more concern because it has been linked to health issues like cancer.

    We should strive to have the safest levels of arsenic possible in our food, beverages and drinking water; however, because arsenic is naturally abundant in our environment, we won’t be able to get rid of it completely. More studies are needed as to the type (organic or inorganic) and the levels of arsenic in juice products, as well as any potential health effects. Evidence available today does not indicate widespread poisoning of our children by drinking fruit juices.

    Americas poison centers recommend that, as parents, you should review all the information available and make decisions you feel are best for your family.

    If you are concerned, you may decide to limit the amount of juice your children drink, have your children drink more water or milk, or dilute the juice with water. And, as always, if you have questions, call the toll-free Poison Help hotline at 1-800-222-1222.

  • Toxicology Question of the Week

    March 30, 2017

    Why is trisodium phosphate in my cereal and is it dangerous to my health?


    Recently, the Tennessee Poison Center has received numerous calls from the public about why their popular brand of cereal (e.g. Cinnamon Toast Crunch) contains a poisonous chemical called trisodium phosphate. Callers had read on the internet or heard by word of mouth that trisodium phosphate is a highly toxic industrial strength cleaner, and they were worried about their children eating it.

    Food-grade trisodium phosphate is often used as a leavening agent for baked goods, an emulsifier for processed cheese, a flavorant for certain beverages, and to control the pH of processed foods.

    Concern over the chemical appeared late 2014 as an image of the Lucky Charms ingredients panel alongside a bottle of trisodium phosphate heavy duty cleaner began circulating the internet. Various websites began to comment on the ingredient and called for readers to tell the FDA to remove it.


    Trisodium phosphate is a very effective cleaning agent and sufficiently alkaline (pH 12 for a 1% solution) to remove grease and oils from surfaces, as well as cause significant chemical burns when in contact with human skin. However, the amount of trisodium phosphate in cereal and other food products is tiny and poses no harm to consumer. It is considered “generally recognized as safe” by the U.S. FDA.





    1. U.S. National Archives and Records Administration. (2006 April 1). Code of Federal Regulations. Title 21, Chapter 1, Subchapter B, Part 182 – Substances Generally Recognized As Safe.
    2. Lampila LE. Applications and functions of food-grade phosphatesAnn N Y Acad Sci. 2013 Oct; 1301:37-44.


    This Question prepared by:  Justin Loden, PharmD, CSPI


    I am interested in any questions you would like answered in the Question of the Week.  Please email me with any suggestion at


    Donna Seger, MD

    Medical Director

    Tennessee Poison Center

    Poison Help Hotline: 1-800-222-1222


    The Question of the Week is available on our website:

  • What is melamine and how did it end up in food products?
    Melamine is used to make a melamine resin and foam which can be used in products such as counter-tops, fabrics, glues, and flame retardants. When melamine is added to a food product, the food �appears to have more protein than it actually does. The reason for this is that melamine and cyanuric acid, a melamine like compound, contain nitrogen in their structures. When an item is tested for its amount of crude protein, the most common measurement is not the actual amount of protein, but rather the amount of nitrogen in a compound. The nitrogen serves as a surrogate marker since nitrogen is in proteins. When melamine is added, the relative nitrogen content is higher, thus the product appears to have a higher protein content for marketing.

    What is the complication from melamine ingestion?
    Small amounts of melamine in the diet will not likely result in disease. Adulteration of food by intentionally adding melamine, however, may result in larger doses of melamine. Renal failure is the end stage disease from ingestion of large doses of the melamine in the diet. After ingestion, melamine and cyanuric acid may form crystals or stones in the urinary system. When unrecognized, these stones may cause an obstructive uropathy that may result in renal failure.

    Where can I get more information?
    There is information and recommendations on the websites of the Food and Drug Administration ( and the Centers for Disease Control and Prevention (
    Any cases of possible melamine poisoning should be reported to the Tennessee Department of Health.(1-800-404-3006)

    Question prepared by: Saralyn R. Williams, M.D. Medical Toxicologist