Bottles, Pacifiers & Sippy Cups Pose Risks For Toddlers

by Heidi Green
May 24, 2012

“Don’t drink and walk” would be a valuable public safety message for toddlers (if only they could read). Although many infants and toddlers use bottles, sippy cups, and pacifiers throughout their day, a new study shows that children ages 0–3 years are treated in the emergency room for injuries involving these items at a rate of one every four hours. Yikes!

Research
A research team from Nationwide Children’s Hospital in Columbus, Ohio sought to quantify the extent of injuries related to bottles, sippy cups, and pacifiers in order to “educate parents, other caregivers, and health professionals about [such] injuries; help improve product design; highlight existing recommendations; and ultimately prevent [such] injuries.”

Dr. Sarah A. Keim and her team obtained data from the National Electronic Injury Surveillance System (NEISS) of the Consumer Product Safety Commission (CPSC) for patients who were treated in hospital emergency rooms between January 1, 1991 and December 31, 2010. They looked particularly at cases related to use of baby bottles, sippy cups, and pacifiers; they excluded cases in which oral use of the device was not the mechanism of injury (e.g., a child got a splinter when reaching for a pacifier, or a child was injured when a sibling threw a bottle). They also excluded fatalities (e.g., due to aspiration of the liquid, or strangulation by a rope on a pacifier).

The researchers looked at the children’s age, which body part was injured, what type of injury occurred, and outcome (e.g., hospitalization or discharge). Mechanism of injury was classified as “fall” or “other,” which included product malfunctions and burns, such as from a heated liquid in a child’s bottle.

Results
Dr. Keim and colleagues estimated that 45,398 infants and toddlers were treated in emergency rooms for injuries related to the use of sippy cups, bottles, and pacifiers. About two-thirds of these injuries (66.4 percent) occurred in 1 year olds. More injuries occurred in boys (61.2 percent) than girls.

Most injuries involved bottles (65.8 percent), but almost one in five involved pacifiers. Sippy cups were involved in 14.3 percent of injuries overall; predictably, sippy cups were seen more with injuries among 2 year olds than 1 year olds.

The mouth was the site of most injuries (71.0 percent) followed by the head, neck, or face (19.6 percent). Lacerations were the most common injury (70.4 percent), while pacifiers were associated with injuries to the soft tissue and teeth.

Since the researchers relied on emergency room data only, their estimates provide a limited look at injuries related to these products. This study did not include injuries that were treated at home, in child care settings, or in doctor’s offices.

Recommendations
Knowing that injuries due to falls while using bottles, pacifiers, and sippy cups are preventable, here are some tips for keeping your child injury-free:

• Give these products to your child only during their recommended ages. For example, the American Academy of Pediatrics (AAP) recommends that parents wean their babies from the pacifier by 1 year of age.
• Use bottles, pacifiers, and sippy cups with your child only when they’re not mobile. For example, use the pacifier only when your infant is sleeping or napping, in accordance with the AAP’s SIDS prevention guidelines. Hold your child in your arms or settle him in a high chair when you give him a bottle.
• Transition your child to an open cup between 12 and 18 months of age, as the AAP recommends.
• Stay aware of product recalls. A small number of instances in this study were related to product failure, such as pacifiers coming apart. The CPSC has recalled more than 16 million pacifiers since 1991 and more than 1 million sippy cups due to safety concerns.

Last but not least, keep your toddler safe by adopting the “don’t drink and walk” rule.