Preventing Unintentional Poisoning

What is unintentional poisoning and why are tamariki at risk?

Preventing unintentional poisoning is critical because our young tamariki are naturally curious and may mistake harmful substances for food or drink. They are active explorers and are attracted to bright, scented things. They are constantly learning about the world around them by putting things in their mouths and by copying us.

They’re not always put off by bitter or sour tastes either, especially if things look like lollies or are stored in the wrong container. Unfortunately, many of these items that are found around the house can poison tamariki even in very small amounts. This includes items like medicines, cleaning products, cosmetics, alcohol and plants.

What is the main cause of unintentional poisoning?

Medications remain the main cause of unintentional poisonings in tamariki (65%), and paracetamol is one of the most common of these medications.

Tamariki have also been unintentionally poisoned when they’re given an incorrect dosage of medication.

Size of the problem in Aotearoa

Every year in Aotearoa:

2 tamariki deaths from unintentional poisoning (ages 0–14)
222 serious hospitalisations (0–14 years) — about 4 hospitalisations per week

Who is being poisoned?

82% of unintentional poisonings happen to our very young tamariki aged 0-4 years old
57% of these hospitalisations were 1-2 year olds.
At 1-2 years old they are beginning to move independently, exploring their surroundings and don’t yet know the difference between what is safe and what is dangerous. Male and female tamariki are hospitalised at similar rates for unintentional poisonings.
More than half of all tamariki that are hospitalised due to poisoning live in the most socio-economically deprived areas of Aotearoa.
Tamariki Māori and children from Middle Eastern, Latin American and African descent are disproportionately affected by unintentional poisonings, having the highest rates of hospitalisation.

The good news

The good news is that there has been a steady decline in hospitalisations from unintentional poisoning in tamariki over the last decade.

Prevention works, and there are simple steps you can take to keep tamariki safe.

Medicine Safety Tips

To prevent tamariki being unintentionally poisoned from medicines, see our top tips below.

Share this information with your whānau and anyone else who is caring for your tamariki, make sure everyone in your whare feels confident around medicines.

Remember that child resistant caps and lids are not child-proof.
Store all medicines, chemicals, and cleaners in their correct containers up high, out of reach and sight of tamariki, ideally in a lockable space.
Always make sure you fully understand your medication. This includes what it's for, how long to take it, potential side effects and the correct dosage.
Ensure you follow the dose instructions from your doctor or pharmacist correctly, and make sure to ask them to explain if you’re not sure:
- For young tamariki use an oral syringe to accurately measure liquid medication.
- Dispose of any unwanted or expired medications safely. You can return any unused or expired medicines to your local pharmacy for safe disposal.
While it’s tempting to refer to medicines and vitamins as lollies, it’s best to avoid doing this as it can encourage tamariki to seek them out.
Ensure you read and follow all safety instructions on medicines.
Use the right tool for the right dose. Measuring syringes are more accurate for liquid medicines.
It’s important to not use household spoons as a measure. Ask your pharmacist or nurse for an oral syringe or medicine cup if you don't have one. These are safer, more accurate and easy to use.
One size fits all dosing doesn’t work for all tamariki. Make sure to give the correct dosage based on age and weight of your tamariki.

*You can use a free paracetamol calculator from Healthify to help you calculate the dosage for paracetamol. Always check with your pharmacist if you are unsure of how much to give.

Giving tamariki too much paracetamol often happens from small mix-ups. It’s easy to give a little too much. Ask your GP or pharmacist to write down your child’s dose clearly and double check if you’re ever unsure.
If the medicine label doesn’t make sense, ask your pharmacist or other health professional to explain it in a way that you understand. You deserve clear instructions, in a way that works for you.
Different caregivers for your tamaiti can mean different routines which can lead to a double dosing risk. Keep a written record/phone notes app record of when your tamaiti has had their medicine. Share it with anyone helping.

Bonjela: What Whānau Need to Know

While Bonjela products are generally safe when used correctly, it's crucial to follow these guidelines:

Consult your healthcare professional before introducing any teething remedies, discuss them with your healthcare provider to ensure they're suitable for your pēpi.
Use the recommended dosage as prescribed by your health professional.
Monitor for any adverse reactions. Be vigilant for any unusual symptoms in your child after using teething products and seek medical attention if concerns arise.

(Image credit: Health Navigator Charitable Trust / Healthify He Puna Waiora, 2024.)

Why is using Bonjela mouth ulcer gel a concern in babies and young children?

The active ingredient in Bonjela mouth ulcer gel is choline salicylate, which can be very harmful to babies and young children if too much is given. It can cause salicylate poisoning.

How much Bonjela mouth ulcer gel to apply

When using Bonjela mouth ulcer in young children, it's important to follow instructions and make sure you don't use too much or use it too often.
For children 18 months of age and over apply a pea sized amount as seen in the image below.

(Image credit: Health Navigator Charitable Trust / Healthify He Puna Waiora, 2024.)

Bonjela alternatives

Teething rings or gently massaging the gums are good alternatives.

Gum Massage: Gently rub your baby's gums with a clean finger to provide relief.
Teething Rings: You can use a chilled (not frozen) teething ring made of firm rubber for your baby to chew on. Ensure it's clean, not dipped in anything, and free from any liquid filling.
Cold Washcloth: A clean, cold washcloth can be soothing for babies to chew on.
Offer extra awhi to pēpi and caregivers during unsettled moments, especially disrupted sleep.

Avoid amber necklaces, as these present a choking and strangulation risk.

*For more information on Bonjela, see Healthify's website.

Cleaning Products: Keeping Tamariki Safe

Tamariki learn by copying us and getting involved in household activities.

Therefore, it's important to store products such as dishwashing powder, dishwashing liquid, hand sanitiser and other cleaning products out of sight and reach of tamariki, preferable locked away.

Store household cleaning products out of reach and sight of tamariki, preferably locked away like dishwashing powder, liquids, tablets, and other cleaning products.
- Low-cost cupboard locks can be bought from your local hardware or homeware store or supermarket.
- Store these cleaning products away after each use; if you become distracted while using a cleaning product, take it with you.
Keep household cleaning products in their original containers.
Turn any spray bottle nozzles to the ‘off’ position immediately after use.
Ensure you read and follow all safety instructions on chemicals and cleaners.

Poisonous Plants in Your Garden

There are many plants found in gardens that are considered poisonous and can cause toxic effects if eaten.

Plants can also cause pain and irritation to the skin such as burns or dermatitis.

Even plants that aren’t considered poisonous can cause harm to tamariki as they can cause irritation, nausea, vomiting, diarrhoea, rash, dermatitis, temperature, swelling and difficulty breathing.

Top Tips

Remove poisons plants so they are out of reach of tamariki
Clear away berries, flowers or plant material that can fall onto lawns or paths so that tamariki can’t put them in their mouth.
Know the names of the plants in your garden and the pot plants in your whare, so you have the right information in case poisoning occurs.

National Poisons Centre Top 10 Poisonous Plants of New Zealand:

Arum Lily
Black Nightshade
Euphorbia
Iris
Oleander
Agapanthus
Ongaonga (New Zealand Tree Nettle)
Hemlock
Foxglove
Rhus

See our infographic below:

First Aid for Poisoning

If poisoning is suspected, phone the National Poisons Centre on 0800 POISON (0800 764 766) or contact a health professional.

Call 111 immediately and ask for an ambulance if your child is:

If the person is unconscious or having difficulty breathing, ring 111 (NZ Only).
In all other poisoning situations call the National Poisons Centre on 0800 POISON.

Follow DRS ABCD to start CPR:

D Dangers? Check for any dangers to you, the child or people nearby.
R Responsive? Check responsiveness by calling loudly and shaking the child's arm. Are they responding? Ask “what’s your name?” or say “open your eyes” or “squeeze my hand”. Then grasp and squeeze the child’s shoulders firmly. If they move or make a noise, that’s a response.
S Send for help. Dial 111 and ask for an ambulance.
A Airway. Open the airway by moving the head into a neutral position and lifting the chin. Tilt their head back and lift their chin, this will open their airway. Make sure the child’s tongue isn’t blocking the airway. If there’s anything in the child’s mouth, use two fingers to sweep it out.
B Breathing. Look and feel for movement of the chest and stomach area. Check for normal breathing. Is their chest moving? Can you hear air coming from their nose and mouth? Occasional gasps for air is not breathing normally.
C CPR. If the child is not breathing, start CPR - 30 compressions to 2 breaths.
D Defibrillator. Attach a defibrillator as soon as it is available and follow prompts. If there is an AED nearby, attach it to the child as soon as possible and follow the instructions on the AED.

*For deaf, hard of hearing or speech impaired you can TXT 111. You must be registered to use this, find out more information below.

Whānau Poisons Safety Resource

Download our key messaging fact sheet here:

Additional Resources and References

For health professionals:

Poisonsous Plants References:

Top 10 Poisonous Plants

Photo: Jeremy R. Rolfe (16 July 2006) (CC BY 4.0), via New Zealand Plant Conservation Network
Photo: Colin C. Ogle (Victoria Park, Whanganui, 20 March 2023) (CC BY-NC 4.0), via New Zealand Plant Conservation Network
Photo: John Smith-Dodsworth (Miranda, January 2023) (CC BY-NC 4.0), via New Zealand Plant Conservation Network
Photo: John Sawyer (Hamilton Road, Herne Bay, Auckland) (CC BY-NC 4.0), via New Zealand Plant Conservation Network
Photo: Richard Hursthouse (CC BY 4.0), via New Zealand Plant Conservation Network
Photo: Peter J. de Lange (Urtica ferox) (CC BY-NC 4.0), via New Zealand Plant Conservation Network
Photo: John Barkla (Digitalis purpurea) (CC BY 4.0), via New Zealand Plant Conservation Network
Photo: Peter J. de Lange (Ellerslie, Auckland, July 2007) (CC BY-NC 4.0), via New Zealand Plant Conservation Network