Poisonous nightcap from poppy seeds

Poppy seeds obtained from mature Papaver somniferum normally contain only small amounts of opium alkaloids. The alkaloid concentration of seeds is usually not under control by Food Administration. We report a poisoning developing disastrous consequences under a peculiar set of coincidences. A 6-week-old female baby (5 kg body weight) ingested about 75 mL of a milk nightcap prepared by her mother as an old household remedy for sedation. 200 grams of poppy seeds were cooked with 500 mL milk and honey. Three hours after ingestion the patient developed disturbances of respiration with CNS depression, miosis, tachycardia, and pale grey marbled skin. Intermittent respiratory arrest was noted ad time of hospital admission. Arterial oxygen saturation was 89% at hospitalization, and dropped further to 69%. The patient was intubated and ventilated. Administration of naloxon was successful to restore spontaneous breathing but repeated intravenous doses were needed for 10 hours (total dose 1 mg, 0,2 mg/kg, respectively).