All 29 children under 4 who tested positive for cannabis in the ER triggered child protection activation, but over 60% of caregivers denied knowledge of exposure.
Pediatric emergency physicians; child protection professionals; cannabis safety advocates.
100% child protection activation; only 3.4% caregiver disclosure
What the researchers found
Over 10 years, 29 children 0-48 months tested positive for cannabis. Neurological symptoms were universal. CPT activated in 100%, police reports 93.1%, CPS contacted 62.1%. Only one caregiver admitted exposure. 37.9% had multiple prior ER visits.
Why it matters
As cannabis products become more available, pediatric exposures increase. Non-specific symptoms and caregiver denial make diagnosis challenging.
The numbers in context
29 cases. 65.5% male. Median age 14 months. CPT: 100%. Police: 93.1%. CPS: 62.1%. Caregiver admission: 3.4%. Multiple prior ER visits: 37.9%.
How the study worked
Retrospective 10-year analysis (2010-2021) at Hadassah Medical Center, Jerusalem. Children 0-48 months with positive cannabis urine toxicology.
What this study cannot tell us
Single center in Jerusalem. Small sample. Retrospective. Cannot determine route or intentionality.
How to read the evidence
Small retrospective case series at a single center.
When this study was published
2025 study
The bigger picture
The tension between cannabis legalization and child safety is real. Multiple ER visits may signal neglect.
Questions still open
- How many exposures go undetected? Should routine toxicology be considered for unexplained pediatric neurological symptoms?
Common questions
How do young children get exposed?
What symptoms did children have?
Read the original research
Cannabinoid exposure in infants and children in the pediatric emergency department-the child protection perspective.
European journal of pediatrics, 184(5), 310
Citation
Fridler, Dvora; Cahan, Lea Ohana Sarna; Moshe, Adi Bracha; Guzner, Noa; Gross, Itai; Hashavya, Saar. (2025). Cannabinoid exposure in infants and children in the pediatric emergency department-the child protection perspective.. European journal of pediatrics, 184(5), 310. https://doi.org/10.1007/s00431-025-06129-1
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