What is the American Academy of Pediatrics' (AAP) new recommendation regarding poison treatment in the home? How does it differ from the AAP's old recommendation?

• The AAP previously advised that parents keep a 1-ounce bottle of syrup of ipecac in the home to induce vomiting if it was believed a child had swallowed a poisonous substance. The AAP now recommends that syrup of ipecac no longer be used routinely at home by parents or caregivers.

What should I do if I still have syrup of ipecac in my home?

• Parents should throw out syrup of ipecac that is currently in their home in a safe manner, such as flushing it down the toilet.

What is the reason for the new recommendation?

• There are several reasons behind the new recommendation. Most importantly, there has never been any evidence that vomiting helps children who eat or drink something poisonous. Also, most emergency rooms have stopped using ipecac in favor of activated charcoal - which binds to poison in the stomach and prevents them from entering the bloodstream. Continued vomiting caused by syrup of ipecac may later result in the child being unable to tolerate activated charcoal or other poison treatments.

Are there other reasons why keeping syrup of ipecac in the home is not a good idea?

• There is also concern that people with eating disorders such as anorexia or bulimia may misuse syrup of ipecac. And in rare cases, parents or caregivers with Munchausen syndrome by proxy - a disorder in which adults purposely make children ill in order to gain attention - have been known to use syrup of ipecac in an abusive manner.

But for years, the AAP and other groups said syrup of ipecac was an important item in the home medicine chest. Why such a drastic change?

• Again, there was never any evidence that giving syrup of ipecac to children to make them vomit decreased death rates due to poisoning. It was a practice based on intuition rather than science. In other words, doctors and parents just assumed that vomiting removes poison from a child's body. For many years, that assumption was never tested or researched. But in the past few years, scientific tests and research have shown vomiting will not help a child who has swallowed a poisonous substance.

If parents can't keep syrup of ipecac in the home, how should they protect their children against poisoning?

• The best defense against unintentional poisoning is prevention. Parents should keep potential poisons locked out of sight and out of reach. Replace child-resistant caps immediately after use, keep all products in their original containers, discard all old medications, and refer to medicine by its correct name - don't call pills "candy".

What should a parent do if their child swallows a potentially poisonous substance?

• When a child swallows a potentially poisonous substance, the advice of a well-trained, well-qualified health professional is needed. Keep the number of the Poison Control Center posted near the phone; the universal number in the U.S. is 1/800-222-1222. Call 9-1-1 if a child is having convulsions, stops breathing or loses consciousness.

What about families who live far away from hospitals? Should they keep syrup of ipecac handy just in case?

• Parents who live in rural or remote areas should still discard any syrup of ipecac in their homes. There is no evidence that shows benefit for children who are treated with ipecac. That fact does not change for those who live far from hospitals.

What about parents and caregivers who are still required by law to keep ipecac in their homes?

• Some state and local agencies require foster parents or home daycare providers to keep syrup of ipecac on hand. These specialized childcare homes should follow all requirements of state and local agencies. But they should also work with these agencies to educate them about the AAP's recommendations and encourage them to change their policies.