A new report is cautioning parents about the risks of seemingly harmless liquid hand sanitizer, after an increase in calls to poison control centers about children who’ve ingested enough of substance to make them dangerously drunk.

Since 2010, poison control center hotlines in the United States have seen almost a 400% increase in calls related to kids under 12 consuming hand sanitizer, CNN reports, citing new analysis by the Georgia Poison Center.

The high alcohol content in liquid hand sanitizer — ranging anywhere from 45% to 95% alcohol, compared to wine and beer at 12% and 5% alcohol — can easily cause alcohol poisoning with just two or three squirts, experts say. Children may become confused, vomit or experience drowsiness, and in extreme cases, a child might stop breathing.

“Kids are getting into these products more frequently, and unfortunately, there’s a percentage of them going to the emergency room,” said Dr. Gaylord Lopez, the center’s director.

He said 3,266 hand sanitizer cases involving young kids were reported to poison control centers in 2010. Last year, that number reached 16,117.

Lopez sent a letter to Georgia’s school systems last week warning parents about the dangers of kids drinking hand sanitizer, explaining that some do it intentionally to get drunk, but others might try it on a dare from friends.

Also, it often looks tasty: for example, a six-year-old girl was recently brought to the hospital, unable to walk and slurring her words, after ingesting some strawberry-flavored hand sanitizer at school. Her blood-alcohol was .179, about twice what’s considered legally drunk for an adult.

She had to be watched overnight for signs of brain trauma, as the alcohol made her fall and hit her head.

“That was very scary,” her mother said. “It could have been very lethal for my child.”

Experts recommend tha tparents and teachers keep hand sanitizer away from where children can get it, and monitor them when they do use it. Nonalcohol-based products or sanitizing wipes are also a safe alternative.

More children getting drunk on hand sanitizer [CNN]

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