How alcohol can kill children

Drunk adults are not an unusual sight, but a reeling eight-year-old is. The story of Candice Kasper, who was found drunk, dirty and full of lice on the streets of Kraaifontein in July 2007 after going missing for two days, sent shock waves through the country.

She was allegedly drinking pineapple beer at her home with a group of adults – including her parents – before she wandered off into the streets, and disappeared. Her parents, themselves inebriated, didn’t notice her absence until several hours later, and according to reports they only reported her missing some two days later.

According to the Cape Argus, Candice was in a bad state when an unidentified woman found her and took her to the Bellville police station. Here she vomited and slept in turns.

While the little girl recovered, and was placed in foster care, the incident highlighted the dangers of intoxication in children.

So how does alcohol affect children?

“When it comes to the effects of alcohol on the body, one must differentiate between adolescents older than 12-14 years, who react in ways that are generally similar to adults; and infants, toddlers and younger children,” says Dr Izak Loftus, forensic and anatomical pathologist from the Pathcare Group.

How alcohol affects the body
This is true across the board, from birth to death: “Ethanol is a central nervous system depressant, which will ultimately lead to respiratory depression and death,” Loftus says.

Firstly, alcohol suppresses the frontal lobes of the brain, then it goes to the back of the brain, and then to the brain stem – each time affecting different body functions.

Acute alcohol intoxication can be risky for anyone. In the first instance you’re more vulnerable to violence and violent people – sexual abuse, fighting, and motor or pedestrian accident deaths commonly involve drunk people. Beyond that, though, you can “drown” in your own vomit when consciousness is depressed.

The same principles that affect blood alcohol concentration (BAC) apply to both adolescents and adults:

  • Body size and weight. “The smaller you are, the less alcohol you can tolerate,” Loftus says. “With all other factors equal, ingestion of 20g of alcohol (approximately two measures) will roughly result in a BAC of 0,03g% in a 100kg male and a level of 0,06g% in a 50kg male. However, a 50kg female will have a BAC of 0,066g%. Drinking on an empty stomach and the taking of prescription medication will have an additional aggravating effect.”
  • Water content of the body; and
  • How often you drink – the enzymes that break down alcohol in the liver become more efficient the more you drink (this function is not as developed in children and other non-drinkers who aren’t used to drinking alcohol).

Why children are more vulnerable
“The ability of children younger than five years to metabolise alcohol is limited, due to the immature enzyme activity in the liver,” Loftus says. “But after the age of 14 years, the rate of blood alcohol concentration decline is the same as in adults.”

However, other factors put babies and children at even greater risk. They get hypoglycaemia (low blood sugar levels) more easily when there’s alcohol in their systems, as well as hypothermia (low body temperature), and can also fall into a coma more easily. These three conditions usually occur when the BAC of a child exceeds 0,05 – 0,10g%. In addition, there is dehydration, and the nausea, vomiting and breathing difficulties common amongst all intoxicated individuals.

Loftus explains that low blood sugar occurs because alcohol inhibits glucose production. The drinking of alcohol also affects the glycogen (the main form in which carbohydrates are stored) stores in the livers of young children. Low body temperature is the result of exposure and the dilation of the peripheral blood vessels.

In children suffering from malnutrition, or in children who haven’t eaten for several hours, the risk increases. If Candice was undernourished and dehydrated at the time she drank the pineapple beer, she would have been affected sooner. “A relatively small amount of alcohol (30 - 60ml) could be a lethal dose,” Loftus says.

Acute alcohol intoxication in infants and toddlers is usually accidental, and may include ingestion of an ethanol-containing substance such as perfume, or over-the-counter medication. Other substances in the ingested fluid may also have additional toxic effects.

Should children abstain from alcohol?
Parents often wonder whether it’s okay for a child to have a few sips of wine on the odd occasion (at Sunday lunch, for instance).

While there are no hard and fast rules, this is probably safe – if a small amount of alcohol is consumed under the watchful eye of a loving parent.

According to Loftus, a small volume of alcohol probably won’t cause any physical harm. Furthermore, it could form an important part of the socialisation and educational process.

But care should be taken. And it’s definitely not a good idea to introduce alcohol to a child younger than 12-14 years.

Alcohol overdose – what to do
Most children, who taste alcohol for the first time, find it unpleasant and don’t pursue it. But when accidental alcohol poisoning occurs, it should be treated as a medical emergency.

“There is a risk that the child could die. It’s irresponsible to tell a child to just ‘sleep it off’,” says Loftus. “The child should be taken to the trauma unit of your nearest hospital immediately.”

(Carine van Rooyen, July 2007)

Read more:
The six stages of drunkenness
Blood alcohol calculations

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