Efficacy of Flow Restrictors in Limiting Access of Liquid Medications by Young Children

Abstract

Objectives Annually, tens of thousands of children are brought to emergency departments for unsupervised medicine ingestions. We assessed whether adding flow restrictors to liquid medicine bottles can provide additional protection against unsupervised medicine ingestions by young children, even when the child-resistant closure is not fully secured. Study Design From April – May 2012, we conducted a block randomized trial with a convenience sample of 110 3- and 4-year-old children from 5 local preschools. Participants attempted to remove test liquid from an uncapped bottle with a flow restrictor and a control bottle without a flow restrictor (with either no cap or an incompletely-closed cap). Results Ninety-six percent (25/26) of open controls and 82% of incompletely-closed control bottles (68/83) were emptied within 2 minutes. Only 6% (7/110) of bottles with flow restrictors were emptied during the 10-minute testing period, none before 6 minutes. Overall, children removed less liquid from bottles with flow restrictors than from open or incompletely-closed controls (both P < .001). All children assigned open controls and 90% assigned incompletely-closed controls removed ≥25 mL liquid. In contrast, 11% of children removed ≥25 mL liquid from uncapped bottles with flow restrictors. Older children (54 – 59 months) were more successful than younger children at removing ≥25 mL liquid (P = .002) from bottles with flow restrictors. Conclusions Findings suggest that adding flow restrictors to liquid medicine bottles limits the accessibility of their contents to young children and could complement the safety provided by current child-resistant packaging.

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