Poison control centers in the U.S. have reported a huge increase in the number of kids under the age of six who have been sickened by nicotine products like pouches and vape e-liquids, says NBC News. From 2010 to 2023, more than 134,663 cases of nicotine poisoning were reported in young children, according to a report published Monday by the American Academy of Pediatrics.

Almost all these tragedies occurred at home. The new research revealed that the rate of poisoning involving nicotine pouches rose from 0.48 per 100,000 children in 2020 to 4.14 cases per 100,000 in 2023, representing a whopping 763% increase in just three years.

While the majority of poisonings weren’t serious, 39 children suffered significant side effects and two toddlers died after ingesting liquid nicotine used in vapes.

“It’s good that the majority of kids in the study actually did pretty well. Most kids had either minor symptoms or no symptoms and didn’t require any medical management,” said Natalie Rine, one of the authors of the new study and director of the Central Ohio Poison Center at Nationwide Children’s Hospital in Columbus. “But two deaths is a lot, especially for something considered a preventable death.”

The rise in accidental poisoning corresponds with a surge in the sales of these pouches, which can contain as much as six milligrams of the stimulant, nicotine.

In January, the U.S. Food and Drug Administration (FDA) authorized the marketing of Zyn nicotine pouch products through the premarket tobacco product application (PMTA) pathway following an extensive scientific review. This is the first time the agency has authorized products commonly referred to as nicotine pouches, which are small synthetic fiber pouches containing nicotine designed to be placed between a person’s gum and lip. It’s important to note that the FDA did not approve these pouches as nicotine replacement patches used to help smokers quit.

The American Lung Association was livid at the marketing approval and said: “We are extremely disappointed that the FDA authorized these Zyn nicotine pouches – especially since the product has been on the market illegally up until now. While it has not been sold in the U.S. for long, we are already seeing very concerning levels of youth use, and troubling use of influencers and celebrities to promote the product, exactly like Juul was promoted previously. One study found there has been a 641% increase in sales of the products between 2019 and 2022, but just 2.9% of U.S. adults had ever used a nicotine pouch. This shows an alarming rate of people younger than 21 using this product.”

Dr. Molly O’Shea, a pediatrician and spokesperson for the American Academy of Pediatrics said with soaring sales of these products, it was just a “matter of time before they fell into the hands of younger kids.”

O’Shea said it’s critical to keep nicotine products away from children, especially toddlers who love to put things into their mouths. Nicotine pouches don’t come in child-proof packaging and often taste good, especially the mint and fruit flavors.

“That doesn’t mean in your purse, back pocket or on the counter,” she said. “It means locked away.” She suggested that parents also talk to their teenagers about the risk of using nicotine pouches that could increase heart rate, blood pressure and lead to nausea, vomiting or even comas in children. It’s also a good idea to add the national Poison Control number to your cell phone: 1-800-222-1222.