Accidental Ethanol Ingestion in a 32 Day Old Infant

Alcohol exposure can occur in all age groups but occurs much less commonly in infants. Prior studies have shown that no level of alcohol exposure is safe, and can affect the brain and other areas of development. We report a 32 day old previously healthy male who presented to an outside hospital early morning for "not acting normal". Earlier that morning, mom had fed him 3 ounces of formula mistakenly prepared with a clear liquid thought to be water, but later confirmed to be gin. The baby was mildly agitated on arrival, and the blood alcohol level 4 hrs post-ingestion was 230 mg/dl. This is one of the youngest documented cases of alcohol ingestion, and was remarkable for having a mild course with normal vital signs and electrolytes, and a non-focal physical exam. This case highlights the importance of having a high level of suspicion for alcohol exposure and a low threshold for checking blood ethanol levels in infants presenting with altered mental status, as there may be no hallmark signs, symptoms, or electrolyte abnormalities.