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Lethal Lullabies: A History of Opium Use in Infants
1Department of Neonatology, Charité University Medicine, Berlin, Germany michael.obladen@charite.de.
Insights
For millennia, poppy extract (opium) was widely used to sedate infants for crying, pain, and teething. Despite known infant toxicity and thousands of deaths, its use persisted until international legislation in 1912 curtailed access.
Area of Science:
- Medical History
- Pediatrics
- Pharmacology
Background:
- Poppy extract, containing opium, has been used for infant ailments for over 3,000 years.
- Historical medical texts and pediatric instructions documented its use for excessive crying, pain, diarrhea, and teething.
- Practices included maternal nipple application and direct infant drugging to facilitate weaning.
Observation:
- Infantile sleeplessness was historically considered a disease, with opium prescribed by prominent physicians.
- Opium was integrated into infant care in foundling hospitals and by wet-nurses.
- Industrialization led to widespread private use among the working class, with opium-based products marketed as 'soothers' and 'cordials'.
Findings:
- Despite widespread knowledge of opium's infant toxicity and numerous documented fatalities, its use in infants continued.
- Physicians frequently prescribed opium for infants throughout history.
- Increased unregulated trade in the 19th century significantly raised infant opiate intoxication rates, contributing to mortality.
Implications:
- Historical use highlights evolving pediatric practices and the long struggle against infant sedation with dangerous substances.
- The International Hague Convention of 1912 marked a turning point, leading to legislation that curbed access to opium and infant sedation.
- Understanding this history informs current approaches to infant care and medication safety.
Abstract:
Poppy extract accompanied the human infant for more than 3 millenia. Motives for its use included excessive crying, suspected pain, and diarrhea. In antiquity, infantile sleeplessness was regarded as a disease. When treatment with opium was recommended by Galen, Rhazes, and Avicenna, baby sedation made its way into early medical treatises and pediatric instructions. Dabbing maternal nipples with bitter substances and drugging the infant with opium were used to hasten weaning. A freerider of gum lancing, opiates joined the treatment of difficult teething in the 17th century. Foundling hospitals and wet-nurses used them extensively. With industrialization, private use was rampant among the working class. In German-speaking countries, poppy extracts were administered in soups and pacifiers. In English-speaking countries, proprietary drugs containing opium were marketed under names such as soothers, nostrums, anodynes, cordials, preservatives, and specifics and sold at the doorstep or in grocery stores. Opium's toxicity for infants was common knowledge; thousands of cases of lethal intoxication had been reported from antiquity. What is remarkable is that the willingness to use it in infants persisted and that physicians continued to prescribe it for babies. Unregulated trade, and even that protected by governments, led to greatly increased private use of opiates during the 19th century. Intoxication became a significant factor in infant mortality. As late as 1912, the International Hague Convention forced governments to implement legislation that effectively curtailed access to opium and broke the dangerous habit of sedating infants.