Is diaper cream containing camphor safe for use on infants?

Diaper Cream Containing Camphor is Not Safe for Infants

Nappy creams containing camphor should not be used on infants due to the risk of toxicity, which can occur even with small amounts applied topically.

Safety Concerns with Camphor in Infants

Camphor is a potentially toxic substance that poses significant risks to infants when used in topical preparations such as diaper creams:

• Camphor can be absorbed through the skin, especially in infants whose skin barrier is not fully developed 1
• Even small amounts of camphor (500 mg) have been associated with serious toxicity and potential fatality in children under 6 years of age 2
• Exposure to as little as 500-1000 mg of camphor has been linked to seizures and death in pediatric populations 2

Specific Risks of Camphor Exposure

When applied topically to infants, camphor can cause:

• Seizures (a common and serious complication)
• Confusion and neurological symptoms
• Muscle twitching, myoclonus, and ataxia
• Rapid onset of symptoms (within 5-15 minutes of exposure) 3

The FDA and other regulatory bodies have taken actions to limit camphor in products due to these safety concerns. Notably, paregoric (which contained camphor) is no longer used in pediatric medicine because it contains toxic ingredients including camphor, anise oil, alcohol, and benzoic acid 1.

Alternative Diaper Care Recommendations

For safe diaper area care in infants, guidelines recommend:

1. Using emollient and liners to reduce friction from diaper elastic on skin 1
2. Cleaning the diaper area with emollient ointment rather than water or commercial wipes 1
3. Using well-fitted standard diapers with the inner elastic trimmed to reduce friction 1
4. Lining diapers with soft cloth liners coated with emollient or paraffin-impregnated gauze 1
5. Using barrier creams without camphor or other potentially toxic ingredients 1

Global Perspective

Camphor-containing balms and oils are commonly used for infants in some regions of the world, but this practice has been associated with adverse events 4. Parents and caregivers should be educated about the risks of these products to prevent child morbidity and potential mortality.

Management of Accidental Exposure

If accidental exposure to camphor occurs:

• Patients who have ingested more than 30 mg/kg or who exhibit symptoms of toxicity should be referred to an emergency department immediately 5
• For topical exposures, the skin should be thoroughly washed with soap and water 5
• Patients exhibiting seizures following camphor exposure require emergency medical care and treatment with benzodiazepines 5

Key Takeaway

The evidence clearly demonstrates that camphor-containing products, including diaper creams, pose significant health risks to infants and should be avoided. There are many safe alternatives available for diaper care that do not contain potentially toxic ingredients like camphor.