Does a child who ingested scented candle wax and subsequently vomited, but is currently asymptomatic, require an emergency room visit?

Candle Wax Ingestion in Children: Emergency Department Evaluation Not Required for Asymptomatic Cases

For a child who ingested scented candle wax, vomited once, and is now acting completely normal, an emergency room visit is not necessary—contact Poison Control (1-800-222-1222) for guidance and monitor at home for any concerning symptoms. 1, 2

Immediate Actions at Home

• Contact Poison Control immediately (1-800-222-1222) to report the ingestion and receive specific guidance on monitoring 1, 2
• Do not induce further vomiting or give ipecac, as this is contraindicated and provides no clinical benefit while potentially causing harm 1
• Do not give water, milk, or activated charcoal unless specifically instructed by Poison Control, as these may cause additional vomiting and aspiration risk 1, 2
• Ensure the child can handle secretions normally and is not drooling excessively 3

Key Assessment Points to Monitor

Watch for any of these warning signs that would require immediate ER evaluation:

• Respiratory symptoms: New or persistent cough, hoarse voice, wheezing, difficulty breathing, or stridor 4
• Inability to swallow or handle secretions: Drooling, gagging, or refusing to swallow 3
• Altered mental status: Lethargy, confusion, seizures, or decreased responsiveness 1
• Persistent vomiting: Continued vomiting beyond the initial episode 5
• Abdominal pain or distension: Severe or worsening abdominal symptoms 5
• Oral cavity burns: Erythema, blistering, or visible injury around the mouth 4

Why ER Visit Is Not Immediately Necessary

Candle wax (typically paraffin-based) is generally considered low toxicity when ingested in small amounts. The fact that the child vomited once and is now asymptomatic is reassuring. The single vomiting episode likely expelled much of the ingested material 4.

However, there is an important caveat: One case report documented a toddler who required bronchoscopy and endoscopy after hot candle wax ingestion with aspiration, where thick wax casts were found in the airways and wax adherent to gastric mucosa 4. This child presented with continuous cough, hoarse voice, and oral burns—all symptoms your child does not have.

When to Seek Emergency Care

Go to the ER immediately if any of these develop:

• Any respiratory symptoms emerge: Even mild cough or voice changes warrant evaluation due to aspiration risk 4
• Signs of esophageal obstruction: Inability to swallow, persistent drooling, or chest pain 3
• Systemic symptoms: Fever, lethargy, or signs of shock (cool extremities, prolonged capillary refill >2 seconds) 1
• Recurrent vomiting: Multiple episodes suggesting ongoing gastric irritation 5

Special Considerations

• Hot vs. cooled wax matters: If the wax was hot when ingested, there is higher risk of thermal injury to the mouth, throat, and esophagus requiring evaluation 4
• Scented candles may contain additives: Fragrances, dyes, and other chemicals could theoretically cause additional irritation, though serious toxicity is uncommon 6
• Lead-wick candles: Older candles (particularly pre-2003) may have lead-core wicks, though toxicity from a single ingestion is unlikely 7

Follow-Up Monitoring

• Observe for 24 hours for any delayed symptoms, particularly respiratory changes 4
• Normal diet can resume once the child is tolerating fluids without difficulty 5
• Watch stool for passage of wax: The wax should pass through the gastrointestinal tract without issue in most cases 4

Common Pitfalls to Avoid

• Do not delay calling Poison Control while searching for information online—they provide real-time, case-specific guidance 1, 2
• Do not assume all is well if respiratory symptoms develop later—aspiration can present with delayed symptoms 4
• Do not give home remedies or "neutralizing" substances—there is no evidence these help and they may cause harm 1