An 8-week-old infant in Los Angeles became ill after his father allegedly mixed the baby’s formula with gin instead of water by accident.

Although it’s not clear whether the father was telling the truth, the baby was found to have a high blood alcohol level — equivalent to about five times the legal limit for an adult operating a motor vehicle.

The baby was brought to the emergency room after his babysitter noticed that the infant was experiencing breathing problems — including gasping for air — and had gone limp. At the hospital, the doctors smelled alcohol on the baby, and ordered a blood alcohol test. The father mentioned the possible gin-water mix-up only after being questioned about the baby’s high alcohol level.

This infant experienced what doctor’s call an “apparent life-threatening event,” or ALTE, an episode that is alarming to an observer because a person displays symptoms such as color change or gagging. When emergency room doctors see a case like this, they must work quickly to figure out what could be wrong with the patient, said Dr. Taylor McCormick, an emergency medicine physician at the Los Angeles County & University of Southern California Medical Center.

Cases of infant alcohol poisoning are rare, and emergency room doctors may not always think to check a baby’s blood alcohol level when they see an ALTE, McCormick said. At McCormick’s hospital, where the baby was treated (McCormick didn’t personally treat the infant), doctors had ordered blood alcohol tests for infants just six times during the course of a year, and knew of only one other case in which the results had come back positive. (The emergency room treats more than 22,000 children a year.)

While McCormick doesn’t think every baby that experiences an ALTE should be screened for alcohol poisoning,  if maltreatment is suspected, alcohol screening should be considered, she said.

McCormick and colleagues describe this case of infant alcohol poisoning in the Jan. 14 issue of the journal Pediatrics.

Not many studies on infant alcohol poisoning have been done, but from what is known, babies appear to metabolize alcohol faster than adults, McCormick said. Symptoms of alcohol poisoning in babies can include difficulty breathing, reduced activity and seizures. Some studies have found a risk for low blood sugar.

The long-term effects on the baby are also unclear, and a one-time event may not cause problems. However, breathing difficulties could deprive the baby’s brain of oxygen, possibly causing brain damage, McCormick said.

The baby featured in the journal article spent several months in the hospital, and was ultimately discharged to the care of foster parents after the Department of Children and Family Services was notified about the case. There was a plan in place for the baby to work with a therapist because the doctors were concerned the baby had a developmental delay, McCormick said. Whether this condition was present before the poisoning, or resulted from it, is hard to say, McCormick said, but “it’s certainly possible that he could have a lasting deficit from the alcohol poisoning.”

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