Thursday, September 28, 2006

Choking Hazard

Hi Lisa,

My 15-month old was recently given a toy with small parts. What is the minimum size of an object that a toddler can safely play with without risk of ingestion/aspiration? Thank you so much for your advice!

“Which Toys are Choking Hazards?”

Dear “Which Toys are Choking Hazards?”,

It is very smart of you to be concerned about the safety of toys. Unfortunately, Asphyxiation due to aspiration of an object into the lungs is the leading cause of accidental death in the home in children under 6 years old.(1) Small balls in particular can easily become lodged into a child’s airway and cause them to asphyxiate.(2) When choosing toys for your child it is important to make sure that there are no small parts that a child could put into his mouth.

In general an object with a diameter of 1.75 inches or smaller poses a high risk of aspiration. (2) Any object, regardless of its size poses a hazard if a child can fit it into his mouth. Young children, older children who are handicapped, or children with a developmental delay are all at risk for putting objects in their mouth and choking on them. There have been reports of children who choked on larger balls that they happened to force into their mouth. The parents didn’t realize the balls were a hazard because they were larger than the size thought to pose a risk. Therefore it is important to teach children not to put any toy into their mouth and for parents to monitor children’s play.

The important thing to remember is that companies are creating new toys and baby products all the time and unfortunately it is not until a number of children become seriously injured will a consumer hear about a problem or recall. (3) The name of the U. S. Government agency that monitors product safety recalls is the Consumer Product Safety Commission or CPSC. The CPSC is committed to protecting consumers and families from products that pose a fire, electrical, chemical, or mechanical hazard or can injure children. (4)

If there is a product recall the CPSC spreads the news to consumers via press releases. (3)This reporting system is not full proof since there is no guarantee that a press release will be picked up by certain media outlets. If the story is picked up there is a chance that the consumer may not hear about the recall if they are not listening to the news at the time. There are no laws or regulations that require manufactures to advertise recalls in newspapers or magazines or to demonstrate that recalled products are returned or taken out of use. (3 ) In many cases it would be impossible for a manufacturer to contact all owners of recalled products. Many toys and baby items are purchased second hand or received as gifts and there is no guarantee that a parent will fill out warranty information cards.

This leaves the responsibility up to the parent to seek out information about product recalls. Parents may find recall information posted in Doctor’s offices and in stores that sell toys and baby products. If a parent is interested in finding out if a product they own has been recalled they can log on to the U.S. Consumer Product Safety Commission website at http://www.cpsc.gov/.

It may take some time from the time an injury occurs to the time a product is recalled. (3) Therefore a parent should always use their judgment and ascertain the safety of an item before giving it to their child. It is not safe to assume that a product is full proof just because it has not been recalled. If you notice that a product is not safe or if your child becomes injured from a product you should call the Consumer Product Safely Commission hot line at (800) 638-2772 or contact the U.S. Consumer Product Safety Commission via the internet at: www.cpsc.gov/talk.html .

Measures that parents can take to prevent their child from choking on an item include:

1. Do not permit children to play with small objects such as coins, buttons or marbles. (1)
2. Keep infants away from balloons whether they are inflated or deflated because they can easily be aspirated.(5)
3. Inspect toys frequently for loose parts and discard them in parts are loose. (1)
4. Do not let infants or toddlers play with stuffed animals that have button type eyes or decorations. Remove the eyes if necessary. (6)
5. Instruct older children to keep their toys away from younger children. (5)
6. Avoid buying young children toys intended for older children because they may have small parts that pose a choking hazard. (5)
7. Look for toys that are well-made with tightly secured eyes, noses and other parts so that children will not be able to twist or pull the parts off. ( 5)
8. Avoid all toys with marbles and games with balls with a diameter less than 1.75 inches. (5)
9. If you receive a product as a gift, buy it second hand or purchase it from a garage sale contact the CPSC via the internet at www.cpsc.gov to see if the product has been recalled.

References:
(1) Betz C, Hunsberger M, Wright S. Family-Centered Nursing Care of Children. 2nd ed. Philadelphia, PA:W.B.Saunders Company. 1994: 537.
(2)Comsumer Product Safety Commission. CPSC Issues Warning That Choking on Small Balls Can Be Fatal to Young Children. Available at:
http://www.cpsc.gov/cpscpub/pubs/5076.html. Accessed Sept 2006.
(3)Understanding Government. UG Report: The U. S. Consumer Product Safety Commission. Available at:
http://understandinggov.org/reports/felcher.html. Accessed Sept 2006.
(4) U. S. Consumer Product Safety Commission. CPSC Overview. Available at:
http://www.cpsc.gov/about/about.html. Accessed Sept 2006.
(5)U. S. Consumer Product Safety Commission. Toy Safety Shopping Tips. Available at:
http://www.cpsc.gov/cpscpub/pubs/toy_sfy.html. Accessed Sept 2006.
(6) Chow M, Durand B, Feldman M, Mills M. Handbook of Pediatric Primary Care. Albany, New York:Delmar Publishers Inc. 1984: 308.


Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice About Keeping Kids Safe

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