Children are especially susceptible to iron poisoning, iron toxicity is diagnosed when iron dosage exceeds 20 mg/kg, severe iron toxicity occurs at 60 mg/kg and fatal poisoning can occur in doses as small as 120 mg/kg. For a child weighing 50 pounds (23 kg) a fatal dose of iron would be roughly 2,760 mg of elemental iron, most OTC iron supplements contain 65 mg of elemental iron per tablet, so a child ingesting 20 tablets would get a toxic dose and 40 tablets could potentially be a fatal dose. Some iron supplements and multivitamins are flavored, they look and taste like candy which makes them appealing, and dangerous to children, a lot of parents don't consider vitamins to be something that can be toxic, but they certainly can be. Iron poisoning can be difficult to spot as the early symptoms are abdominal pain, diarrhea and vomiting, which are usually symptoms of a number of common childhood illnesses. What really makes iron poisoning deadly is there is a period of no symptoms, the initial GI symptoms appear between 30 minutes to six hours after ingestion, after about six hours those symptoms subside and the patient starts feeling better. However between 24 to 72 hours later the third stage of iron poisoning occurs and presets with low blood pressure, rapid breathing, shortness of breath, tachycardia, hypovolemic shock and liver failure. By this point severe organ damage is starting to occur and without treatment by the time liver failure beings it is typically fatal.
