One of our pediatricians asked if one could safely put vanilla in infant formula to make it taste better. Great question; this is the answer. . . /ds
Besides the obvious bottle of Tennessee whiskey in your pantry cabinets, there are many household items that contain concentrated alcohol in your home including hand sanitizers, colognes and perfumes, astringents, and even food flavoring extracts.
Food flavoring extracts (vanilla extract, almond extract, lemon extract, etc.) contain up to 35% ethanol. The problem in using these products is in their application to foods that are ready to eat. Flavoring extracts should not be given to children unless heat has been applied and the alcohol has been cooked out. When extracts are not cooked or baked out of food, they do not taste good, and a small amount could be potentially dangerous for a child.
10 mL of vanilla extract containing 35% ethanol gives a 6 kg child an estimated blood alcohol level > 80 mg/dL, putting the child at risk for CNS depression, respiratory depression, and hypoglycemia.
In an abstract published for the North American Congress of Clinical Toxicology annual meeting in 2015, the authors describe the abuse of lemon extract in an adolescent case. The authors also describe the lack of restriction for purchase and compare the alcohol content of extracts with that of bourbon and absinthe.
If you have questions or are treating a symptomatic patient, please call the Poison Center to speak with one of our Specialists in Poison Information at 1-800-222-1222.
This question prepared by: Nena Bowman, PharmD, SPI (Specialist in Poison Information) Tennessee Poison Center
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Donna Seger, MD
Tennessee Poison Center
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