Infantile methemoglobinemia caused by food additives

A small outbreak of toxic methemoglobinemia occurred among infants in a pediatric ward. Investigation revealed that the most likely source of toxicity was an approved fat preservative which had been added to a soybean infant formula by the manufacturer. This fat preservative contained three phenolic compounds having highly effective antioxygenic properties (butylated hydroxyanisole, butylated hydroxytoluene and propyl gallate). The outbreak ceased when the offending agents were eliminated from the food preparation. It is emphasized that the approval of chemicals for use in the food industry through toxicity studies does not necessarily guarantee against the hazards of toxicity, especially during infancy.