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Flow Restrictors May Help Prevent Medication Poisonings in Young Children

Each year, half a million calls are made to poison centers for medication overdoses in young children and the number of emergency department (ED) visits due to children getting into medicines is rising, with more than 60,000 young children brought to an ED every year because they got into medicines while an adult wasn’t looking.
CDC worked with the Georgia Poison Center on the first study to examine how effective devices called flow restrictors—adapters added to the necks of liquid medicine bottles to limit the amount of liquid that can come out of the bottle, even when turned upside down, shaken, or squeezed—can be for preventing young children from getting into liquid medicines. To see how well flow restrictors work when an adult does not correctly lock the safety cap, researchers filled medicine bottles with strawberry syrup and asked 110 pre-school aged children to try to get all of the liquid out.

  • Secondary barriers: Flow restrictors are intended to work with current child-resistant packaging, such as child safety caps, to help keep young children from getting into medicines when adults aren’t looking. Child safety caps are designed to prevent, or at least delay, young children from opening bottles so that an adult may intervene, but caregivers must correctly re-secure the cap after each and every use in order for them to be effective.
  • Medicine bottles with improperly locked safety caps: When children were given bottles with safety caps that were not locked all the way, 82 percent completely emptied these bottles in just 2 minutes. 90 percent of children removed 25 mL (5 typical doses) or more of the liquid.
  • Uncapped medicine bottles with flow restrictors: When children were given uncapped bottles with flow restrictors, only 6 percent completely emptied these bottles before the end of the 10 minute test. Only 11 percent of children were able to remove 25 mL or more of the liquid. While the three flow restrictor designs tested in this study performed well, all designs might not perform equally well. A next step is to develop safety standards for testing flow restrictors.

Although improved packaging can help keep young children from getting into medicines, caregivers should always remember to correctly lock child safety caps after every use and store medicines up and away and out of sight of young children.

Graphics / Images

  • Image of three bottles with flow restrictors and their accompanying oral syringes.

    Medicine bottles with flow restrictors

    This is a description for image 1

  • Image of a young child turning over a bottle with a flow restrictor

    A young child turns over a medicine bottle containing strawberry syrup to show how a flow restrictor in the neck of the bottle limits the amount of liquid released.

    This is a description for image 1

  • Image of a young child turning over a bottle with a flow restrictor.

    A young child turns over a medicine bottle containing strawberry syrup to show how a flow restrictor in the neck of the bottle limits the amount of liquid released.

    This is a description for image 1

  • Alt text for 508: Image of a young child turning over a bottle with a flow restrictor.

    A young child turns over a medicine bottle containing strawberry syrup to show how a flow restrictor in the neck of the bottle limits the amount of liquid released.

    This is a description for image

Contact Information

CDC Media Relations
(404) 639-3286
media@cdc.gov

Spokespersons

Dan Budnitz, MD, MPH, CAPT, USPHS

Biography

Dan Budnitz, MD, MPH, CAPT, USPHS

It’s important to remember that flow restrictors are designed as a secondary barrier and caregivers should not rely on these devices alone. The best way to keep young children from getting into medications is to fully lock child safety caps and put medicines up and away and out of sight every time you use them.

Dan Budnitz, MD, MPH, CAPT, USPHS - Director of the Centers for Disease Control and Prevention’s Medication Safety Program

Maribeth Lovegrove, MPH

Biography

Maribeth Lovegrove, MPH

The findings of this new study suggest that adding flow restrictors to liquid medicine bottles could complement the safety provided by current child-resistant packaging; however, standards are needed to ensure that other flow restrictor designs are as effective as the ones we tested in this study.

Maribeth Lovegrove, MPH - Epidemiologist in the Centers for Disease Control and Prevention’s Medication Safety Program

 
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