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Are Slushy Drinks Dangerous for Small Children?

— U.K. introduced regulations after glycerol in slushies may have led to illness in kids

MedpageToday
A photo of a person holding a Slurpee in front of a 7-Eleven store.

In February of this year, headlines splashed across U.K. media: "Boy, four, after drinking slushy, mother says," " as 'unconscious' tot hospitalized after slurping iced slushy drink," "My 3-Year-Old Son From Drinking a Slushy; Now I Want Them Banned."

According to these reports, two separate children in England and Scotland, ages 3 and 4, were hospitalized after drinking frozen slushies. One, according to these news reports, fell unconscious, and the other suffered a seizure. Their symptoms were seemingly consistent with glycerol intoxication.

Glycerol or glycerin is a common additive in the U.S. and abroad. It's a sugar alcohol used in everything from soaps and toothpastes to vapes, explosives, and yes, frozen treats like slushies.

In foods, it is often used as a solvent or a sweetener, or to keep in moisture. In slushies, it can be used to sweeten and help keep the treat from freezing to maintain a smooth, slushy consistency. But in high enough doses, glycerol can also cause problems.

Following the incidents in the U.K., regulatory authorities from and issued new guidelines for manufacturers, instructing them to limit glycerol to the minimum amount needed for a "slush" effect, to include a warning visible to consumers against slushies for children 4 and under, and recommending against free refills where children under 10 are served.

Earlier this month, a pediatric emergency physician in the U.S. around 7-Eleven's Free Slurpee Day with some words of caution. "A lot of these slushy-type drinks use something called glycerin or glycerol," Meghan Elizabeth Beach Martin, MD, of Johns Hopkins All Children's Hospital in Saint Petersburg, Florida, also known as @beachgem10 on TikTok, said in the widely viewed video. "And unfortunately, in higher doses younger kids can develop symptoms." She listed headache, nausea, vomiting, diarrhea, and agitation. At worst, Martin said, they can go into shock, lose consciousness, and have hypoglycemia.

Experts say Martin is not wrong. However, like with everything humans can ingest, they urged moderation over panic. "I know that glycerol is a product that is safe enough for general consumption," said Lewis Nelson, MD, chief of medical toxicology at Rutgers New Jersey Medical School. "It's a problem if you take too much of it. But that could be said of virtually anything."

"Just don't go out there and drink three Slurpees when you only need to drink half of one, right?" he said. "But also, don't feel like Slurpees are like drinking cyanide."

Notably, in a communication about glycerol, warned that 125 mg/kg of body weight per hour would be the lowest dose of glycerol associated with negative health effects.

Using this logic, they wrote, a toddler and an adult drinking a slushy drink with 39,000 mg/L of glycerol should only consume between 50 and 220 ml of slushy depending on body weight, or no more than 8 fluid ounces. This is equivalent to the small size Slurpee you'd get from 7-Eleven on Free Slurpee Day, though it's not clear if these slushies contain glycerol, and if so, at what concentration.

According to the ingredients list for a number of (the U.S. site does not appear to list Slurpee ingredients), the slushy drinks contain carbonated water followed by "sugars (sugar/glucose-fructose)." This may mean that alcohol sugars are among the ingredients, but it may not.

Ingredient lists for Icees, sold at gas stations and fast food chains, do not include glycerin or glycerol. Nor do Sonic's Slushes. Both popular options contain high-fructose corn syrup and do not list "sugars." A handful of ice cream flavors from and , however, do include glycerin.

One expert told 鶹ý he thought there must be more to the story. "I cannot imagine that anyone would add enough glycerin to any Slurpee/slushy to produce any problems," said Steven Marcus, MD, former director of the New Jersey Poison Control Center. "I know my grandchildren, ages 5 and 8, do share a Slurpee, and never drink the full container at a time anyway."

Still, he quoted the "father of toxicology," Paracelsus, who coined the phrase often shortened to, "The dose makes the poison."

Meanwhile, according to Nelson, glycerol is not a new ingredient. It's even used as the base for many children's medications, like , he said. Nelson's successor at the New Jersey Poison Control Center, Diane Calello, MD, also said she had not heard of any problems with slushies, though glycerin's laxative effects could cause diarrhea.

"It's safe enough to put in our medications, so in and of itself, it's not that dangerous a product," Nelson said. "But if you take too much of it, it could cause problems. I mean, it is a sugar alcohol. It can cause diarrhea. It can cause neurological symptoms."

"My sense of what happened in the U.K., there was a bad case or two, so they looked at it and regulated. Whereas ... we don't really hear about this stuff here."

The FDA was not able to respond to 鶹ý queries in time for publication. 7-Eleven also did not respond in time for publication.

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    Sophie Putka is an enterprise and investigative writer for 鶹ý. Her work has appeared in the Wall Street Journal, Discover, Business Insider, Inverse, Cannabis Wire, and more. She joined 鶹ý in August of 2021.